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La téléconsultation est un acte médical pris en charge par la sécurité sociale pour le suivi des patients depuis 2018 mais qui a connu un essor phénoménal avec la crise COVID de 2020. Le Conseil National Professionnel d'Allergologie a souhaité enquêter auprès de ses membres à ce propos. 82,1 % n'utilisait pas cet outil avant la crise mais pendant celle-ci 86,4 % des médecins l'ont fait et 66,8 % le font encore en 2021. La téléconsultation leur sert principalement pour le renouvellement d'une immunothérapie allergénique, de traitements symptomatiques et pour annoncer un bilan biologique. Un allergologue sur deux trouve "intéressant" le fait de pouvoir recevoir ainsi des nouveaux patients, notamment pour des patients dans un désert médical, une histoire d'allergie médicamenteuse ou une urticaire chronique. 57,3 % pensent gagner du temps grâce à la téléconsultation. On note ainsi que cet exercice de la médecine à distance est rentré dans les habitudes des allergologues qui ont su se l'approprier et l'adapter à leur pratique. Teleconsultation has been a reimbursed tool for monitoring patients since 2018 but which experienced a phenomenal boom with the COVID crisis of 2020. The National Professional Council of Allergology wanted to survey its members in this regard. 82.1% did not use this tool before the crisis but during it 86.4% of the doctors did it and 66.8% still do it in 2021. The teleconsultation is used mainly for the renewal of an allergen immunotherapy, symptomatic treatments and to announce a biological assessment. One in two allergists find it "interesting" to be able to receive new patients in this way, especially for patients in a medical desert, with a history of drug allergy or chronic urticaria. 57.3% think they save time thanks to teleconsultation. We note that this tool has become a habit of allergists who have known how to appropriate and adapt it to their practice. [ABSTRACT FROM AUTHOR]

La biologie est un outil incontournable dans le diagnostic et la prise en charge des patients allergiques. L'apprentissage à l'interprétation d'un bilan biologique est essentiel pour le praticien. En raison de la diversité des cursus, les jeunes allergologues n'ont pas tous la même formation. À la demande du Conseil Scientifique de la Société française d'allergologie (SFA), le Groupe de Travail Biologie de l'Allergie a réalisé une enquête auprès des jeunes allergologues afin d'évaluer leur niveau de formation en biologie de l'allergie et de connaître leurs attentes en termes de formation continue. Au total, 162 allergologues ont été contactés et 36 ont répondu. Les répondants étaient majoritairement des femmes (78 %), allergologues exclusifs (83 %) et 69 % étaient issus du DES d'Allergologie. La moitié estimait avoir eu une formation suffisante en biologie de l'allergie et 50 % ont effectué un stage dans un laboratoire de biologie médicale. Soixante-trois pour cent se considéraient comme compétents pour l'interprétation des bilans. Pour leur formation continue, ils utilisaient les sites internet des sociétés savantes, les revues scientifiques et des webinaires qu'ils jugeaient satisfaisants. Aucune personne n'avait recours à un système d'évaluation des compétences. Plus de 95 % des répondants sont en faveur d'une mise à disposition de documents synthétiques de référence et tous les consulteraient s'ils étaient accessibles en ligne sur le site de la SFA. En conclusion, la formation des jeunes allergologues sur la biologie de l'allergie a besoin d'être complétée et harmonisée, sur le plan théorique et pratique. Plusieurs outils pédagogiques sont plébiscités pour le maintien des compétences. Blood tests are an essential tool for the diagnosis and management of allergy. Learning how to interpret test results is therefore essential for the physician. Due to the diversity of their education, young allergists do not all have the same training. At the request of the French Society of Allergology (SFA) Scientific Committee, the In vitro Diagnosis Working Group carried out a survey for young allergists in order to evaluate their level of initial training in allergy in vitro diagnosis and to know their expectations in terms of continuing medical education. A total of 162 allergists were consulted and 36 responded. Half of them considered that they had sufficient training in allergy in vitro diagnosis and 50% considered themselves competent in the interpretation of tests. For their continuing medical education, they use the websites of learned societies (SFA, EEACI), scientific journals and webinars and consider them satisfactory or very satisfactory. More than 95% of them are in favour of the online availability of summary sheets or reference documents in in vitro diagnosis, and all of them would consult these tools if they were accessible on the SFA website. In conclusion, the training of young allergists in allergy blood tests needs to be completed and standardised, both theoretically and practically. Several educational tools are available and popular to achieve this and help them to keep valuable skills up to date. [ABSTRACT FROM AUTHOR]

Le rhumatologue et l'interniste peuvent être sollicités tant pour le diagnostic étiologique que pour la prise en charge thérapeutique d'une uvéite. L'étude prospective ULISSE (Uvéites: évaluation clinique et médico-économique d'une stratégie standardisée pour le diagnostic étiologique) a montré l'intérêt d'une stratégie diagnostique orientée selon le type anatomo-clinique de l'uvéite. Une analyse secondaire a montré qu'une faible proportion d'examens était utile au diagnostic. Ces examens sont peu coûteux, simples et guidés par les données cliniques. Les uvéites des spondyloarthrites suivent une « règle des 90 » : 90 % d'entre elles sont unilatérales, aiguës et antérieures. Environ 2/3 des spondyloarthrites sont diagnostiquées au moment de l'uvéite. L'existence de douleurs rachidiennes d'allure inflammatoire ou non doit faire rechercher une spondyloarthrite qui représente la première cause d'uvéite dans les pays occidentaux. Le risque de cécité est exceptionnel; la problématique est celle des récurrences (50 à 60 %). La sulfasalazine diminue la fréquence, la durée et l'intensité des uvéites et peut être proposée à titre préventif. La sarcoïdose est une cause sous-estimée d'uvéites (jusqu'à 15 %), notamment chez les femmes d'âge mûr. Le traitement des uvéites sarcoïdosiques s'apparente à celui des uvéites idiopathiques. Les uvéites de la maladie de Behçet affectent des individus jeunes, des deux sexes, de toute origine et se présentent habituellement comme une panuvéite et une vascularite rétinienne. Le traitement des uvéites associées à la maladie de Behçet a pour objectif l'obtention d'un calme oculaire total. Le pronostic des formes sévères et réfractaires a été transformé par les anticorps monoclonaux anti-TNF-α. Rheumatologists and internists may need to establish the etiological diagnosis and handle the therapeutic management of adults with uveitis. A prospective study named ULISSE (Uveitis: clinical and medicoeconomic evaluation of a standardized strategy for etiological diagnosis) has shown that a standardized strategy for the etiological diagnosis of uveitis was neither inferior nor superior to an open strategy. Subsequent analysis showed that only a few diagnostic tests were useful for the etiological assessment of uveitis. These tests were often inexpensive, simple, usually guided by clinical findings, and allowed an etiological diagnosis to be made for many patients. Three systemic diseases are particularly prevalent in patients referred to internists or rheumatologists: HLA-B27- and spondyloarthritis-associated uveitis, Behçet's disease, and sarcoidosis. Uveitis associated with spondyloarthritis follows a « rule of 90 »: around 90 of cases are unilateral, anterior, and acute. Among patients with uveitis and spondyloarthritis, about two thirds are diagnosed with joint disease during a uveitis assessment. Patients with inflammatory or noninflammatory low back pain should be routinely evaluated for spondyloarthritis, which is the leading cause of uveitis in western countries. The risk of blindness is extremely low, and the main complication is recurrent uveitis, seen in 50 to 60 % of cases. Sulfasalazine decreases the frequency, duration, and severity of uveitis and can be used prophylactically. Sarcoidosis is an underestimated cause of uveitis, which occurs in 15 % of cases, with a predilection for middle-aged women. The treatment of sarcoid uveitis largely follows the general principles of idiopathic uveitis. Behçet's disease uveitis affects young people of both sexes and of all origins and usually presents as panuveitis and retinal vasculitis. The treatment of Behçet's uveitis aims at a complete disappearance of the ocular inflammation. The prognosis of the severe and refractory forms has been dramatically changed by the introduction of TNF-α antagonists. [ABSTRACT FROM AUTHOR]

L'immunothérapie allergénique est le seul traitement étiologique des allergies. La forme sublinguale est un traitement à prendre quotidiennement au minimum pendant 3 ans. L'observance des patients est un problème majeur car seulement 15 % des patients terminent les 3 ans. Afin d'améliorer cette problématique, il faut en identifier les causes (financières, effets secondaires, absence d'amélioration clinique, mauvaise compréhension du traitement ou lassitude) pour proposer au patient une solution adaptée (suivi personnalisé, encouragements, informations régulières). Les moyens technologiques modernes comme la télémédecine, les applications mobiles, les réseaux sociaux sont également des outils au service de l'allergologue pour accompagner le patient dans sa prise en charge. Allergen immunotherapy is the only etiological treatment for allergies. The sublingual form is a long treatment, to be taken daily for at least 3 years. Patient adherence is a major problem as only 15% of patients maintain it for 3 years. To improve this, it is necessary to find the causes (financial, side effects, lack of clinical improvement, poor understanding of the treatment or forgetfulness) to give to the patient a suitable solution (personalized follow-up, support, available information). Modern technological means such as telemedicine, mobile applications, social networks are also tools for the allergist to help the patient to continue his allergen immunotherapy. [ABSTRACT FROM AUTHOR]

En 2018, une enquête déclarative a été menée auprès de patients allergiques sous immunothérapie depuis au moins 5 mois. Cinq milles sept cent soixante réponses ont été reçues entre janvier et fin décembre 2018. Les trois quarts des patients utilisaient la forme sublinguale en gouttes. La majorité des patients s'estimait améliorée par l'immunothérapie et n'avait plus besoin de prendre de traitement symptomatique. Quatre-vingt pour cent des patients avaient moins voire n'avaient plus d'absentéisme. Ainsi, 89 % jugeaient l'immunothérapie efficace à très efficace. In 2018, a declarative survey was conducted among allergic patients receiving immunotherapy for at least 5 months. Five thousand seven hundred and sixty responses were received between January and the end of December 2018. Three-quarters of patients were using a sublingual drop formulation. Most patients felt better following desensitization and no longer required symptomatic treatment. 89% considered desensitization effective to very effective. [ABSTRACT FROM AUTHOR]

Abstract Engineered nanomaterials are used in various applications due to their particular properties. Among them, Iron Oxide Nanoparticles (Fe 2 O 3 -NPs) are used in Biomedicine as theranostic agents i.e. contrast agents in Magnetic Resonance Imaging and cancer treatment. With the increasing production and use of these Fe 2 O 3 -NPs, there is an evident raise of Fe 2 O 3 -NPs exposure and subsequently a higher risk of adverse outcomes for the environment and Human. In the present paper, we investigated the effects of an intravenous daily Fe 2 O 3 -NPs exposure on Wistar rat for one week. As results, we showed that several hematological parameters and transaminase (ALT and AST) levels as well as organ histology remained unchanged in treated rats. Neither the catecholamine levels nor the emotional behavior and learning / memory capacities of rats were impacted by the sub-acute intravenous exposure to Fe 2 O 3 -NPs. However, iron level in plasma and iron content homeostasis in brain were disrupted after this exposure. Thus, our results demonstrated that Fe 2 O 3 -NPs could have transient effects on rat but the intravenous route is still safer that others which is encouraging for their use in medical and/or biological applications. [ABSTRACT FROM AUTHOR]

La biologie est un outil incontournable dans le diagnostic et la prise en charge des patients allergiques. Pour compléter l'enquête auprès des jeunes allergologues publiée en 2022, le Groupe de travail biologie de l'Allergie (GTBA) en partenariat avec l'ANAFORCAL a réalisé une nouvelle enquête auprès des allergologues seniors afin d'évaluer leur formation en biologie de l'allergie et de connaître leurs attentes en termes d'information et formation continue. Au total, 1092 allergologues ont été contactés (avec des doublons entre les deux listes) et 219 ont répondu. Les allergologues s'estiment être bien formés. Plus de 70 % estiment avoir de bonnes connaissances sur le sujet et 94 % se forment régulièrement sur le sujet, en congrès tout d'abord, par la lecture d'articles scientifiques puis en réunions de formation locales. Sur cet échantillon, 69,4 % ont lu les recommandations sur la biologie de l'allergie publiées en 2021. Parmi ceux qui l'ont lu, 90 % en sont satisfaits. Cependant sur cet échantillon, 89 % n'ont jamais fait de stage dans un laboratoire d'immunoallergologie pendant leurs études. Cette enquête rapporte que 95 % des répondants veulent plus de formation et information, à propos des nouveaux allergènes moléculaires, puis de l'exploration des angiœdèmes bradykiniques, des puces à allergènes, à propos de la tryptase et enfin pour le suivi de l'immunothérapie allergénique (ITA). Ces thématiques sont souhaitées en formation DPC en ligne, au congrès francophone d'allergologie (CFA), ou sous forme de fiches sur le site de la Société française d'allergologie (SFA). Biology is an essential tool in the diagnosis and management of allergic patients. To complete the survey of young allergists published in 2022, the Allergy Biology Working Group (GTBA) in partnership with ANAFORCAL has carried out a new survey of senior allergists to assess their training in allergy biology and to know their expectations in terms of information and continuing education. A total of 1095 allergists were contacted (with duplicates between the two lists) and 219 responded. Allergists consider themselves to be well trained. More than 70% believe they have a good knowledge of the subject and 94% receive regular training on the subject, first at congresses, by reading scientific articles and then at local training meetings. Of this sample, 69.4% have read the recommendations on the biology of allergy published in 2021. Of those who have read it, 90% are satisfied with it. However, of this sample, 89% had never done an internship in an immuno-allergology laboratory during their studies. This survey reports that 95% of respondents want more training and information, about new Activé par Editorial Manager® and ProduXion Manager® about Aries Systems Corporation molecular allergens, then the exploration of bradykine angioedema, allergen chips, about tryptase and finally for the follow-up of immunotherapy allergen (ITA). These themes are desired in online CPD training, at the French-speaking congress of allergology (CFA), or in the form of sheets on the site of the French Society of Allergology (SFA). [ABSTRACT FROM AUTHOR]

Guidelines recommend to explore mild delayed hypersensitivity reactions to beta-lactams (BL) in children with direct drug provocation tests (DPTs). The optimal duration of these DPTs remains unknown and DPTs lasting 1 to 10 days are proposed. No study has directly compared the frequency of positivity of directs DPTs according to their duration. To compare the frequency of positivity of DPTs of different duration performed to explore mild delayed hypersensitivity reactions to beta-lactams (BL) in children in different centers. Data from children explored between January 2019 and December 2021 for delayed mild reactions (isolated urticaria, maculopapular exanthema or non-specific skin rashes) to oral BL in six different pediatric centers performing DPTs of varying duration (1 day or 3 days or 2 days more than the index reaction) were analysed. In total, 673 children were included. The duration of the DPTs were 1 day in 60 cases (8.9%), 3 days in 69 cases (10.3%), and 2 days more than the index reaction in 544 cases (80.8%). The median age at the index reaction was 1.7 years [0.8–3.7] in the "group 1 day", 1.9 [1–3.6] years in the group "3 days" and 1.5 [1–3.3] in the group "2 days more". Amoxicillin was the main BL involved (72.8%). The median age at workup was 4.6 years [2.7–8.7] in the "group 1 day", 3.8 years [1.8–8.3] in the "group 3 days" and 3 years [1.7–7] in the group "2 days more". General characteristics of patients in the 3 groups were similar. Fifty-eight DPTs were positive (8.6%); reactions occurring during DPTs were all mild and delayed isolated skin rashes resolving spontaneously or with H1-antihistamines. One DPT was positive in the "group 1 day" (1.5%), 4 (5.8%) in the "group 3 days", and 53 (9,7%) in the "group 2 days more than the index reaction" (P = 0.08). The frequency of positive DPTs was higher for long DPT ("2 days more") than short DPT (1 or 3 days) (3.9% vs. 9.7%, P < 0.05). Our results support that increasing the duration of DPTs to explore mild delayed reactions to BL in children may improve their diagnosis performance. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

L'objectif est la comparaison des performances diagnostiques de deux puces IgE multi-allergéniques de composition et de principe différents. Vingt et un patients polysensibilisés ou ayant présenté une anaphylaxie inexpliquée ont été testés par deux puces : la puce ISAC® et la puce ALEX2®. La concordance globale des résultats entre les deux puces est très bonne (97,8 %) pour les allergènes communs. L'analyse par famille moléculaire montre une plus grande fréquence de positivité d'ALEX® pour les LTP (7,4 % versus 5,8 %), alors que c'est l'inverse pour les PR-10 (14,9 % en ISAC® versus 11,9 % en ALEX®). Cependant, les concentrations observées ne sont pas comparables et sont plus élevées en ALEX® pour les PR-10. Comme attendu, le prétraitement par un inhibiteur spécifique bloque l'interférence des IgE anti-CCD dans la puce ALEX®. L'analyse par patient a permis de mettre en évidence des sensibilisations à certains allergènes moléculaires spécifiques de chaque puce : viandes, poissons et pistache présents uniquement sur ALEX2® ou alpha-Gal sur ISAC®. Les résultats obtenus avec les deux puces sont globalement concordants pour les allergènes communs. Une puce plus complète associant des extraits comme des allergènes moléculaires non disponibles pour certains en unitaires devrait trouver sa place dans l'exploration d'anaphylaxie inexpliquée, mais le choix et le nombre d'allergènes testés devrait évoluer pour répondre au mieux aux besoins cliniques. The aim is to compare the diagnostic performances of two multi-allergenic IgE microarrays of different composition and principle. Twenty-one patients with polysensitivity or unexplained anaphylaxis were tested by two microarrays: the ISAC® biochip and the ALEX2® biochip. The overall agreement of results between the two biochips was very good (97.8%), Analysis by molecular protein family shows a higher frequency of ALEX® positivity for LTP (7.4% versus 5.8 %), while the opposite is true for PR-10 (14.9% for ISAC® versus 11.9% for ALEX®). However, the concentrations observed in ALEX® for PR-10 are higher. As expected, a pretreatment by a specific inhibitor blocked the interference of anti-CCD IgE in ALEX® biochip. The analysis by patient allowed to highlight sensitizations to some specific components of each biochip: meat, fish, and pistachio present only on ALEX2® or alpha-Gal on ISAC®. The results obtained with the 2 biochips are generally consistent for common allergens. A more complete chip combining extracts as molecular allergens not available in individual tests should find its place in the exploration of unexplained anaphylaxis but the choice and number of allergens tested should evolve to best meet clinical needs. [ABSTRACT FROM AUTHOR]

La graine de tournesol est un aliment avec un fort potentiel sensibilisant mais finalement peu d'allergies confirmées. Les modes de sensibilisation sont multiples, respiratoires, digestifs et cutanés. De nombreuses manifestations cliniques ont été décrites, les profils des patients sont également très variés. Des réactions à l'huile de tournesol sont possibles mais exceptionnelles. Des prick-tests avec l'aliment natif et la recherche d'IgE spécifiques confirmeront le diagnostic. La recherche d'allergènes moléculaires a permis d'identifier notamment une LTP et des albumines 2S. Nous rapportons une série de cas déclarés au Réseau d'Allergo-Vigilance® et faisons une revue de la littérature sur le sujet. Sunflower seed is a food with a high sensitising potential but few allergies have been confirmed. Sensitization modes are multiple, respiratory, digestive and cutaneous. Numerous clinical manifestations have been described, and patient profiles are also very various. Reactions to sunflower oil are possible but very rare. Prick tests with the native food and the search for specific IgE antibodies will confirm the diagnosis. The search for molecular allergens has allowed the identification of LTP and 2S albumin. We report a series of cases declared to the Allergy-Vigilance Network®, and review the literature on the subject. [ABSTRACT FROM AUTHOR]

La santé a, comme le reste de la société, profité des avancées technologiques dès la fin du 20e siècle. La e-santé s'inscrit dans différents domaines, à la fois pour les patients, pour les soignants et pour les institutions. Chaque spécialité médicale s'est impliquée différemment dans chacun des domaines. En allergologie, la téléconsultation s'est particulièrement développée depuis 2020 alors que la téléexpertise est très peu utilisée. Les réseaux sociaux sont pourvoyeurs de beaucoup d'informations sur les allergies mais sans aucun contrôle sur la véracité de celles-ci. Les différentes facettes de l'allergologie peuvent être découvertes et approfondies en ligne grâce à de nombreux sites et applis, aux contenus rédigés ou contrôlés par des médecins. Il reste encore de nombreuses voies à explorer, notamment l'intelligence artificielle et les objets connectés. Health has, like the rest of society, benefited from technological advances since the end of the 20th century. This e-health corresponds to different areas, both for patients, for caregivers and for institutions. Each medical specialty is involved differently in each area. In allergology, teleconsultation has particularly raised since 2020, while tele-expertise is very little used. Social Medias are providers of a lot of information on allergies but without any control on the veracity of these. The different facets of allergology can be discovered and deepened online thanks to numerous sites and apps, with content written or checked by doctors. There are still many ways to explore, including artificial intelligence and connected objects. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Background: Kawasaki-like syndrome (KLS) is rare in adults; one third of these patients are infected by Human immunodeficiency virus (HIV). Our study reports cases of KLS occurring in HIV-positive adults and reviews the literature to compare their characteristics with HIV-negative adults and children with Kawasaki disease (KD). Methods: Report of cases and review of the literature. Results: Amongst 20 cases reviewed, including 4 who were managed at our institution, KLS was associated with severe immunosuppression and a high HIV viral load. There was frequent co-infection by hepatitis viruses. Desquamation and liver abnormalities were more frequent in HIV-negative adults whereas headaches and gastrointestinal disorders more common in HIV-positive adults. Intravenous immunoglobulin was effective therapy. Relapse was more frequent among HIV-positive patients. No cardiovascular complications or deaths occurred. Conclusions: Advanced immunosuppression due to HIV may predispose to KLS. The differential diagnosis that must be considered includes drug hypersensitivity reactions and staphylococcal infections. [Copyright &y& Elsevier]

Copyright of European Review of Applied Psychology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Review of Applied Psychology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To describe 2 cases of adult Kawasaki Disease (KD) and to review the medical literature to better define the epidemiological, clinical, laboratory, histopathological, cardiovascular, and therapeutic aspects of adult KD compared with pediatric KD. Methods: Report of 2 cases, and review of the literature using a Medline search from 1967 to June 2003. Results: Including our 2 cases, there are 57 reports of adult KD, 74% among patients aged 18 to 30 years. Nine cases of KD associated with human immunodeficiency virus (HIV) infection were described, suggesting that an immunocompromised state may predispose to this syndrome. The incidence of specific diagnostic criteria was roughly similar in adults and in children. However, cheilitis, meningitis, and thrombocytosis were observed in a larger percentage of children, while arthralgia, adenopathy, and liver function abnormality were more common in adults. Although adult KD often was diagnosed after the acute phase, when a significant beneficial effect from gammaglobulin infusion could not be expected, this treatment did appear to shorten the course of the disease. Coronary aneurysms were less frequent in adults than in children. Prognosis was more favorable in adults, with less cardiovascular complications and no deaths. Conclusions: Adult KD is a rare condition, which may go unrecognized. Other known disease processes with similar clinical presentations such as hypersensitivity drug reaction and toxic shock syndrome must be ruled out. For adult KD, exclusion criteria such as absence of hypotension, visceral impairment, staphylococcal infection, and any drug able to induce a drug hypersensitivity reaction are suggestive of the diagnosis, in the presence of the inclusion criteria, rash, conjunctival effusion, oropharynx changes, extremity changes, or adenopathy. [Copyright &y& Elsevier]