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Severe Kawasaki disease in a 3-month-old patient: a case report.

Leonardi S, Barone P, Gravina G, Parisi GF, Di Stefano V, Sciacca P, La Rosa M - BMC Res Notes (2013)

Bottom Line: Kawasaki disease is a multi-system vasculitis which usually occurs in children under 5 years of age.In infants under three months of age, it is very rare and usually associated with a high incidence of incomplete or atypical forms, often unresponsive to treatment.We describe a 3-month-old infant who developed early and severe aneurysms in three coronary arteries despite a timely administration of intravenous immunoglobulins, followed by three days of intravenous methylprednisolone.

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Affiliation: Unit of Broncho-Pneumology and Cystic Fibrosis, Department of Medical and Pediatric Science, University of Catania, Via Santa Sofia 78, Catania 95123, Italy. leonardi@unict.it.

ABSTRACT

Background: Kawasaki disease is a multi-system vasculitis which usually occurs in children under 5 years of age. In infants under three months of age, it is very rare and usually associated with a high incidence of incomplete or atypical forms, often unresponsive to treatment. This condition increases the risk of cardiovascular complications such as coronary artery aneurysms.

Case presentation: We describe a 3-month-old infant who developed early and severe aneurysms in three coronary arteries despite a timely administration of intravenous immunoglobulins, followed by three days of intravenous methylprednisolone.

Conclusion: This case report underlines that the development of coronary artery aneurysm correlates with a delayed diagnosis and treatment, incomplete or atypical forms of the disease, and additionally the severity of clinical presentation, especially in cases of very young infants below 3 months of age. Our case is notable because of the very young age of the patient, the severity of clinical presentation with an early development of coronary artery aneurysms and the unresponsiveness to the therapy.

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Echocardiography. After second treatment with intravenous immunoglobulin the patient developed ectasia of left coronary artery and a worsening of the dilatation of right coronary artery.
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Figure 5: Echocardiography. After second treatment with intravenous immunoglobulin the patient developed ectasia of left coronary artery and a worsening of the dilatation of right coronary artery.

Mentions: After this treatment the patient developed fissuring of the lips, hydrocele (Figure 4), ectasia of left coronary artery (LCA) and a worsening of the dilatation of RCA (RCA: 0.45 cm; LCA: 0.32 cm) (Figure 5).


Severe Kawasaki disease in a 3-month-old patient: a case report.

Leonardi S, Barone P, Gravina G, Parisi GF, Di Stefano V, Sciacca P, La Rosa M - BMC Res Notes (2013)

Echocardiography. After second treatment with intravenous immunoglobulin the patient developed ectasia of left coronary artery and a worsening of the dilatation of right coronary artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4222112&req=5

Figure 5: Echocardiography. After second treatment with intravenous immunoglobulin the patient developed ectasia of left coronary artery and a worsening of the dilatation of right coronary artery.
Mentions: After this treatment the patient developed fissuring of the lips, hydrocele (Figure 4), ectasia of left coronary artery (LCA) and a worsening of the dilatation of RCA (RCA: 0.45 cm; LCA: 0.32 cm) (Figure 5).

Bottom Line: Kawasaki disease is a multi-system vasculitis which usually occurs in children under 5 years of age.In infants under three months of age, it is very rare and usually associated with a high incidence of incomplete or atypical forms, often unresponsive to treatment.We describe a 3-month-old infant who developed early and severe aneurysms in three coronary arteries despite a timely administration of intravenous immunoglobulins, followed by three days of intravenous methylprednisolone.

View Article: PubMed Central - HTML - PubMed

Affiliation: Unit of Broncho-Pneumology and Cystic Fibrosis, Department of Medical and Pediatric Science, University of Catania, Via Santa Sofia 78, Catania 95123, Italy. leonardi@unict.it.

ABSTRACT

Background: Kawasaki disease is a multi-system vasculitis which usually occurs in children under 5 years of age. In infants under three months of age, it is very rare and usually associated with a high incidence of incomplete or atypical forms, often unresponsive to treatment. This condition increases the risk of cardiovascular complications such as coronary artery aneurysms.

Case presentation: We describe a 3-month-old infant who developed early and severe aneurysms in three coronary arteries despite a timely administration of intravenous immunoglobulins, followed by three days of intravenous methylprednisolone.

Conclusion: This case report underlines that the development of coronary artery aneurysm correlates with a delayed diagnosis and treatment, incomplete or atypical forms of the disease, and additionally the severity of clinical presentation, especially in cases of very young infants below 3 months of age. Our case is notable because of the very young age of the patient, the severity of clinical presentation with an early development of coronary artery aneurysms and the unresponsiveness to the therapy.

Show MeSH
Related in: MedlinePlus