Concurrent Adrenal Neuroblastoma and Kawasaki Disease in a 1
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Kawasaki disease is an acute vasculitis of childhood that predominantly affects the coronary arteries. The etiology of KD remains unknown; however, an infectious agent is strongly suspected based on clinical and epidemiologic features. It typically affects children younger than 5 years of age. The peak age of incidence of KD is from 6 months to 2 years of age and it is rare in infants ?3 months old. The highest annual incidence rates of KD are reported from Japan with 206.2 and 239.6 per 100,000 children aged 0 to 4 years in 2009 and 2010, respectively.

Neuroblastoma is the most common extracranial solid tumor in children, accounting for 8% to 10% of all childhood cancers. The prevalence is about 1 case per 7,000 live births, and there are about 800 new cases of neuroblastoma per year in the United States. It is the most common cancer diagnosed during infancy and occurs most frequently in children less than 5 years of age, with a median age of 17 months at presentation. We here report an extremely rare case of an infant diagnosed with concurrent Kawasaki disease and neuroblastoma.

An 18-month-old girl was admitted to our infectious diseases department with a fever for 6 days and puffy red eyes. On physical examination, she was acutely ill, febrile, and irritable. Bulbar conjunctivitis, facial erythema at midline, red fissured lips, and a strawberry tongue were other significant findings. There were also several small bilateral cervical lymphadenopathies, the greatest of which was 1.5 × 1.0?cm. On hospital day 2, mild swelling and desquamation developed on her hands and feet. Transthoracic echocardiography demonstrated a 3?mm dilatation in her right coronary artery, and a diagnosis of Kawasaki disease was made....