Kawasaki Disease in Adolescents: Current Knowledge, Clinical Challenges, and Long-Term Care

Background: Kawasaki disease (KD) is an acute vasculitis of childhood that usually affects children under five but can also present in adolescence. Although less common, adolescent cases pose unique diagnostic and therapeutic challenges due to atypical features and increased cardiovascular risk. Methods: A targeted PubMed search, supplemented by a Google Scholar screening, was conducted to identify studies on KD in adolescents published between 2000 and 2024. Nine studies were included in the synthesis, along with one national surveillance study. This scoping review was conducted in accordance with the PRISMA-Scr guidelines. Results: Adolescents with KD often do not meet full diagnostic criteria, leading to delays or missed diagnoses. Presentations frequently involve symptoms that mimic those of mucocutaneous, gastrointestinal, musculoskeletal, and neurological conditions. These delays are linked with higher rates of coronary artery abnormalities compared with younger children. Intravenous immunoglobulin (IVIG) remains the primary treatment, though resistance occurs more frequently in this group. Beyond the acute illness, adolescent KD impacts school participation, physical activity, and independence, underscoring the importance of addressing developmental and psychosocial outcomes. Conclusions: While KD is primarily a disease of younger children, adolescent cases require greater clinical awareness, prompt intervention, and developmentally informed follow-up to reduce complications and support effective transition to adult care.