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Case of adult-onset Kawasaki disease and multisystem inflammatory syndrome following SARS-CoV-2 vaccination
  1. Christopher R Showers1,
  2. Jaslyn M Maurer1,
  3. Doreen Khakshour1 and
  4. Mohit Shukla2
  1. 1Medicine, NewYork-Presbyterian Queens, Weill Cornell Medicine, Queens, New York, USA
  2. 2Division of Rheumatology, Medicine, NewYork-Presbyterian Queens, Weill Cornell Medicine, Queens, New York, USA
  1. Correspondence to Dr Christopher R Showers; crs7004{at}nyp.org

Abstract

Kawasaki disease (KD) and multisystem inflammatory syndrome (MIS) are rare conditions that occur predominately in children. Recent reports document KD and MIS in adult patients following infection with SARS-CoV-2. Rarely, MIS is observed following vaccination against SARS-CoV-2, mostly in patients with prior SARS-CoV-2 infection. We report a case of KD in a man after a second SARS-CoV-2 vaccine dose, in absence of concurrent or prior SARS-CoV-2 infection. This patient also met criteria for probable MIS associated with vaccination. He tested negative for SARS-CoV-2 RNA via reverse transcriptase PCR, negative for SARS-CoV-2 nucleocapsid antibodies and demonstrated high levels SARS-CoV-2 spike protein antibodies, commonly used to assess vaccine response. Symptom improvement followed treatment with intravenous immunoglobulin, including desquamation of the hands and feet. As widespread vaccination against SARS-CoV-2 continues, increased vigilance and prompt intervention is necessary to limit the effects of postvaccination inflammatory syndromes.

  • COVID-19
  • Immunological products and vaccines
  • Vaccination/immunisation
  • Unwanted effects / adverse reactions
  • Rheumatology

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Footnotes

  • Contributors CRS and JMM drafted the initial manuscript; CRS managed subsequent revisions; DK and MS contributed to manuscript revisions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.