A 14.5-Year-Old Boy with Coronary Obstruction after Kawasaki Disease: A Case Report
Kawasaki disease (KD) is a febrile vasculitis and is considered a leading cause of acquired coronary artery disease in children. A clinically critical complication is the coronary artery aneurysm, which may progress and lead to coronary stenosis or even obstruction. Herein, we describe a 14.5-year-old boy with a history of KD at 6 months old, who developed multiple aneurysms along all the coronary branches. During the follow-up at the age of 14 years, the left coronary artery aneurysms regressed, while the aneurysm of the right coronary artery persisted and was complicated by obstruction at its proximal part, according to computed tomography angiography. However, the patient at the last follow-up was asymptomatic and well.
The serious nature of KD coronary complications warrants follow-up visits. Since echocardiography alone may fail to reveal stenosis or obstruction, other adjunct follow-up imaging modalities such as conventional, computed tomography, and magnetic resonance angiography should be performed in patients with coronary aneurysms.
2. Gordon JB, Kahn AM, Burns JC. When children with Kawasaki disease grow up: myocardial and vascular complications in adulthood. J Am Coll Cardiol 2009;54:1911-1920.
3. De Ferranti SC. Burns JC. Newburger JW. Kawasaki disease (Mucocutaneous Lymph Node Syndrome). In: Allen HD, Shaddy RE, Penny DJ, Feltes TF, Cetta F, eds. Moss and Adams’ Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult. 9th ed. Philadelphia/Baltimore/New York/London/Buenos Aires/Hong Kong/Sydney/Tokyo: Wolters Kluwer; 2016. p. 1355-1371.
4. Gordon JB, Burns JC. Management of sequelae of Kawasaki disease in adults. Glob Cardiol Sci Pract 2017;2017:e201731.
5. Yan F, Zhang H, Xiong R, Cheng X, Chen Y, Zhang F. Effect of Early Intravenous Immunoglobulin Therapy in Kawasaki Disease: A Systematic Review and Meta-Analysis. Front Pediatr 2020;8:593435.
6. Ghareep AN, Alkuwari M, Willington F, Szmigielski W. Kawasaki disease: diagnosis and follow-up by CT coronary angiography with the use of 128-slice dual source dual energy scanner. A case report. Pol J Radiol 2015;80:526-28.
7. Tsuda E, Kamiya T, Ono Y, Kimura K, Kurosaki K, Echigo S. Incidence of stenotic lesions predicted by acute phase changes in coronary arterial diameter during Kawasaki disease. Pediatr Cardiol 2005;26:73-79.
8. van Stijn D, Planken RN, Groenink M, Streekstra GJ, Kuijpers TW, Kuipers IM. Coronary artery assessment in Kawasaki disease with dual-source CT angiography to uncover vascular pathology. Eur Radiol 2020;30:432-441.
9. Mandal S, Pande A, Mandal D, Sarkar A, Kahali D, Panja M. Various coronary artery complications of Kawasaki disease: series of 5 cases and review of literature. J Cardiovasc Dis Res 2012;3:231-235.
10. Kim JW, Goo HW. Coronary artery abnormalities in Kawasaki disease: comparison between CT and MR coronary angiography. Acta Radiol 2013;54:156-163.
|Issue||Vol 17 No 2 (2022): J Teh Univ Heart Ctr|
|Mucocutaneous lymph node syndrome Coronary aneurysm Coronary stenosis|
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