The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Glossary AbbreviationsKDKawasaki diseaseSLEsystemic lupus erythematosusIVIGintravenous immunoglobulinsAST-Aspartate aminotransferaseALT-Alanine transaminase.. aneurysms, a second patient with rash, fever, aseptic meningitis, and seizures, and a third patient with fever, rash, and pleural effusion. Diagnoses: The first patient was finally diagnosed with SLE and KD, the second patient initially diagnosed as KD but eventually SLE and the third patient was diagnosed at onset as lupus but finally diagnosed as KD. Interventions: The first patient was treated with IVIG, corticosteroids, aspirin, coumadin and mycophenolate mofetil. The second patient was treated with IVIG, corticosteroids and methotrexate and the third patient with IVIG, aspirin and corticosteroids. Lessons: Both diseases may mimic each other’s clinical presentation. KD in adolescence presents with MS417 atypical indicators, incomplete presentation, and develop coronary complications more commonly. An adolescent with fever and rash should include KD and SLE in the differential diagnosis. 16. Thrombocytopenia17. Autoimmune hemolysis10. Leucopenia or lymphopenia10. Immunologic disorder:??1. anti-DNA antibody to native DNA or??2. anti-Sm antibody or??3. Positive antiphospholipid antibodies:????1) IgG or IgM anticardiolipin????2) positive lupus anticoagulant (LA) or????3) false positive test for syphilis11. Thrombocytopenia18. Antinuclear antibodies (ANA)11. Positive antinuclear antibody by IFT or an comparative assayC3, C4 MS417 Markedly reduced. Immune Complexes 1,350 mcg/ml. Urianalysis: proteinuria and hematuria.Aspirin 75 mg for 8 weeks. 3 years later. PDN 2 mg kg day.KD and SLEMarchetto et al. (7)Male15 yoFever, cheilitis, strawberry tongue, bilateral non exudative conjunctivitis with hemorrhages in the left vision and diffuse maculopapular rash, hands and feet with periungueal digital peelingButterfly rash on his face, arthralgia, muscle weakness, headacheANA, antineurtrophil cytoplasmatic antibody, anti- DNA were unfavorable. Positive anticardiolipin autoantibodies.IVIG and acetyl salicylic acid. Recurrent KD Methylprednisolone an a second cycle of IVIGKDDiniz et al. (6)Female13 yoFever (7 days), bilateral bulbar nonexudative conjunctivitis, erythema of the oral an pharyngeal mucosa, cervical lymphadenopathy (2cc), erythema of Palms an diffuse maculopapular rashIrritability, myalgia and arthritis (edema and tenderness in elbows and proximal interphalangeal joints in both hands an ankles),Hemoglobin 9.7 gr/dl Urianalysis: Proteinuria 0.57 g/24 h. Leukocytes 3,000, Rabbit Polyclonal to NKX61 Erythrocytes 1,000 Positive ANA 1:320, anti-dsDNA 516, anti-Ro. Unfavorable anticardiolipin C3 42, C4 5IVIG (2 g/kg do), and aspirin 80 mg/kg day Three pulses of intravenous methylprednisolone. PDN 30 mg/d Chloroquine Diphosphate, Azathioprine, aspirin 100 mg/d.KD and SLEDiniz et al. (6)Female4 yoFever (12 days), bilateral bulbar nonexudative conjunctivitis, cheilitis and strawberry tongue, cervidal lymphadenopathy (1.5cc), erythema of Palms, diffuse maculopapular rash, desquamation of the fingers and toes and in periungual region. 1 year later Irritability, Acute swelling of the eyelids, hands and feet, hypertension and pericarditisHemoglobin 7.4 g/dl, Leukocytes 3,800, Lymphocytes 874 Urinalysis: Leukocyturia Erythrocyturia Proteinuria g/24 h, C3 71 C4, 010 ANA 1:320 Anti-dsDNA 654.IVIG (2 g/kgdo), and aspirin 80 mg/kg day 1 year later Three pulses of Intravenous methylprednisolone Cyclophosphamide Chloroquine DiphosphateKD and SLEAgarwal et al. (8)Female9 yoFever (Intermittent) Bilateral conjunctival erythema ECHO moderate dilatation of the LMCA, and diffuse MS417 ectasia of the LAD, moderate mitral regurgitation suggestive of carditis.Abdominal pain arthralgias (ankles, wrists, right knee) weakness of lower extremities aphtous ulcer under the tongueHemoglobin 11.3 g/dL Leukocytes 3,100 ANA 1;2560 Positive Coombs Anti- dsDNA 200Ethosuximide (discontinued) Intravenous Methylrednisolone pulse therapy (30 mg/kg day) for 3 days. Oral Steroids Methotrexate Hydroxychloroquine Aspirin (81 mg/day)SLEAgarwal et al. (8)Female6 yoFever Conjunctivitis non- exudative Cervical Adenopathy Rash 2 days later Recurrence of fever 2 day later Recurrence of Fever Sandpaper-like rash Cervical Lymphadenopathy ECHO dilated LMCAArthralgias (Ankle and Knee) Abdominal PAIN 4 days later Sinovitis of her wrists and knees.Hemoglobin 9 g/dL ANA 1:640 Myeloperoxidase antibodies 28 mg/dL. 4 days later Hemoglobin 9.7 g/dL Platelet Count number 530 k/ml Low C3 complement 64 mg/dL. Normal C4 complement ANA 1:2560 Myeloperoxidas and proteinase 3 antibodies unfavorable. Antibodies-DSdna 200 Positive Combs Positive ENA-RNPIntravenous Gammaglobulin 2 g/kg Aspirin 2 days later Intravenous Gammaglobulin 2 g/kg Aspirin 2 day later Intravenous Methylrednisolone pulse therapy (30 mg/kg day) for 3 days. Oral Steroids MS417 Hydroxicloroquine Aspirin 81 mg (daily) MethotrexateSLEAgarwal et al. (8)Male (Family history for Lupus and Sarcoidosis)13 yoEczema Fever (intermittent) Pruritic Rash Chill Bilaterally Injected Sclera Cervical Lymphadenopathy Bullous pemphigoid rash to the extremities Non pitting edema.