Evidence that the incidence of Kawasaki disease (KD) in siblings is much higher than general incidence, indicates that genetic factors may contribute to the susceptibility. We report a girl with KD whose mother also suffered from KD with the precise medical record when she was a child. Case Reports:Mother (27 years old); At 6 years of age, she was admitted to the reginal hospital because of persistent high fever for 4 days and cervical lymphadenitis. According to the medical record of 21 years ago, she fulfilled the revised criteria of KD. After admission, acetylsalicylate (ASA) was administered and became afebrile within 2 weeks, and then desquamation of fingertips was observed. Two months later, she was admitted for investigation of coronary artery lesion (CAL). The angiographic examination indicated normal coronary arteries, no aneurysms, and no abnormal dilatation of abdominal artery. ASA was ceased without any coagulation problems. Daughter (1 year old); A 1 year-old girl was admitted to the regional hospital with high fever for 3 days and cervical lymphadenitis. On admission, she fulfilled the revised criteria of KD. The BCG-injected site was reactivated and inflamed. And, the combination therapy of oral ASA and the high-dose intravenous gamma-globulin (1 g/kg for 2 days) was administered. However, high fever was still persisted, and she was estimated at the highest risk for CAL, and transferred to our hospital to be subjected to plasma exchange (PE) therapy on day 7 according to our inclusion criteria of PE. After the PE therapy both clinical manifestation and laboratory data were improved to normal ranges. The serial echocardiography revealed intact coronary arteries. Discussion: Two-generation KD may be an appropriate example to analyze the genetic predisposition of KD. It may be important to take a careful history of childhood diseases in the parents of children with KD.
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Mori, M., Kurosawa, R., Miyamae, T. et al. Two-generation Kawasaki Disease: Mother and Daugher. Pediatr Res 53, 173 (2003). https://doi.org/10.1203/00006450-200301000-00118