Simultaneous development of Kawasaki disease in identical twins: A case report

Kawasaki disease (KD) is the most common vasculitis in childhood that affects medium-sized arteries, particularly coronary arteries. The etiology remains unknown; however, many studies suggest that specific genetic factors and/or some infectious agents underlie the onset. Here, we report a set of identical twin boys who simultaneously developed KD, emphasizing the genetic component of etiology. The patients were 4-year-old twin boys who previously had been healthy and had no family history of KD. Twin A, on admission, met four of five diagnostic criteria for KD. Echocardiogram ruled out coronary artery lesion, and he was treated with 2 g/kg IVIG and aspirin, to which he responded well. Twin B, unlike his brother, met only three of the diagnostic criteria, so was diagnosed as incomplete KD. However, due to the history and shared genetic potential for KD, laboratory investigations and echocardiogram were done. His echocardiogram revealed coronary artery lesion. He was also treated with IVIG and aspirin.