{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:12:16Z","timestamp":1788502336257,"version":"build-2803163510"},"reference-count":13,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,21]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>An adolescent boy was admitted on illness day 6 with fever and left cervical lymphadenopathy. He had been treated for complete Kawasaki disease (KD) approximately a decade earlier. He subsequently developed painful swelling of the left wrist and bilateral finger and toe interphalangeal joints, impairing grip strength; ultrasonography confirmed synovitis. Although fever resolved by illness day 12, arthritis persisted. New conjunctival injection, lip erythema and a secondary rise in C-reactive protein led to a diagnosis of incomplete KD on illness day 18, followed by intravenous immunoglobulin. Arthritis rapidly improved and he was discharged without residual joint symptoms or coronary artery abnormalities. KD-associated arthritis may vary by disease phase, with acute-phase polyarthritis sometimes involving small joints and later arthritis affecting larger joints. Distinguishing this presentation from systemic juvenile idiopathic arthritis can be challenging; serial reassessment of the clinical course and treatment response is essential.<\/jats:p>","DOI":"10.1136\/bcr-2026-272465","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:25:20Z","timestamp":1788499520000},"page":"e272465","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Recurrent incomplete Kawasaki disease with small-joint-predominant arthritis during the acute phase"],"prefix":"10.1136","volume":"19","author":[{"given":"Kentaro","family":"Suzuki","sequence":"first","affiliation":[{"name":"Pediatrics, Kariya Toyota General Hospital, Kariya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9649-521X","authenticated-orcid":false,"given":"Soichiro","family":"Ishimaru","sequence":"additional","affiliation":[{"name":"Pediatrics, Kariya Toyota General Hospital, Kariya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Mihara","sequence":"additional","affiliation":[{"name":"Pediatrics, Kariya Toyota General Hospital, Kariya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Kisohara","sequence":"additional","affiliation":[{"name":"Pediatrics, Kariya Toyota General Hospital, Kariya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"2026090322251297000_19.9.e272465.1","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1007\/s00431-020-03582-y","article-title":"Clinico-laboratory profile of Kawasaki disease with arthritis in children","volume":"179","author":"Guleria","year":"2020","journal-title":"Eur J Pediatr"},{"key":"2026090322251297000_19.9.e272465.2","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s10238-019-00547-w","article-title":"Prevalence and characteristics of arthritis in Kawasaki disease: a Chinese cohort study","volume":"19","author":"Peng","year":"2019","journal-title":"Clin Exp Med"},{"key":"2026090322251297000_19.9.e272465.3","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1007\/s10067-025-07770-9","article-title":"Kawasaki disease in adolescents: age-specific clinical features and factors associated with outcomes","volume":"45","author":"Choi","year":"2026","journal-title":"Clin Rheumatol"},{"key":"2026090322251297000_19.9.e272465.4","doi-asserted-by":"publisher","DOI":"10.1111\/ped.14326"},{"key":"2026090322251297000_19.9.e272465.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000484"},{"key":"2026090322251297000_19.9.e272465.6","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001295"},{"key":"2026090322251297000_19.9.e272465.7","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2021.665815","article-title":"Kawasaki Disease and Systemic Juvenile Idiopathic Arthritis - 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