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Unusual imaging presentation of infantile atypical Kawasaki disease

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ABSTRACT

Kawasaki disease is a systemic medium vessel vasculitis of unknown etiology affecting children under 5 years of age. There are no specific diagnostic tests, and thus, the diagnosis of the disease is primarily made on the basis of clinical criteria. Unusual presentations of Kawasaki disease have been variably reported from different parts of the world. However, presentation of the disease in the form of peripheral thromboembolism and florid non-coronary aneurysms has rarely been described This report describes the imaging findings in infantile atypical Kawasaki disease with aneurysms of multiple medium-sized arteries, including coronary arteries, emphasizing the detection of clinically silent aneurysms in the disease.

No MeSH data available.


Related in: MedlinePlus

Axial CT angiography image at the level of aortic sinus shows giant aneurysm of left anterior descending artery (short arrow) with aneurysm of right coronary artery (long arrow)
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Figure 3: Axial CT angiography image at the level of aortic sinus shows giant aneurysm of left anterior descending artery (short arrow) with aneurysm of right coronary artery (long arrow)

Mentions: Subsequently, ultrafast low-dose CT angiography (Philips Brilliance 40 Slice CT scanner; PHILIPS USA) was done in emergency settings which confirmed the color Doppler findings and additionally showed aneurysms of bilateral common carotid, extracranial internal and external carotid, and bilateral vertebral arteries [Figure 2]. There were aneurysms involving multiple coronary arteries, with giant fusiform aneurysm of left anterior descending artery measuring 13 mm [Figures 3 and 4]. CT angiography of thoraco-abdominal aorta revealed small saccular aneurysm at the origin of celiac artery measuring 29 × 25 mm, with fusiform dilatation of superior mesenteric artery [Figure 5A and B]. There were non-thrombosed fusiform aneurysms of bilateral common iliac artery and common femoral artery without the involvement of the main aortic trunk [Figure 6]. The caliber of thoraco-abdominal aortic trunk was normal with distal smooth tapering.


Unusual imaging presentation of infantile atypical Kawasaki disease
Axial CT angiography image at the level of aortic sinus shows giant aneurysm of left anterior descending artery (short arrow) with aneurysm of right coronary artery (long arrow)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036337&req=5

Figure 3: Axial CT angiography image at the level of aortic sinus shows giant aneurysm of left anterior descending artery (short arrow) with aneurysm of right coronary artery (long arrow)
Mentions: Subsequently, ultrafast low-dose CT angiography (Philips Brilliance 40 Slice CT scanner; PHILIPS USA) was done in emergency settings which confirmed the color Doppler findings and additionally showed aneurysms of bilateral common carotid, extracranial internal and external carotid, and bilateral vertebral arteries [Figure 2]. There were aneurysms involving multiple coronary arteries, with giant fusiform aneurysm of left anterior descending artery measuring 13 mm [Figures 3 and 4]. CT angiography of thoraco-abdominal aorta revealed small saccular aneurysm at the origin of celiac artery measuring 29 × 25 mm, with fusiform dilatation of superior mesenteric artery [Figure 5A and B]. There were non-thrombosed fusiform aneurysms of bilateral common iliac artery and common femoral artery without the involvement of the main aortic trunk [Figure 6]. The caliber of thoraco-abdominal aortic trunk was normal with distal smooth tapering.

View Article: PubMed Central - PubMed

ABSTRACT

Kawasaki disease is a systemic medium vessel vasculitis of unknown etiology affecting children under 5 years of age. There are no specific diagnostic tests, and thus, the diagnosis of the disease is primarily made on the basis of clinical criteria. Unusual presentations of Kawasaki disease have been variably reported from different parts of the world. However, presentation of the disease in the form of peripheral thromboembolism and florid non-coronary aneurysms has rarely been described This report describes the imaging findings in infantile atypical Kawasaki disease with aneurysms of multiple medium-sized arteries, including coronary arteries, emphasizing the detection of clinically silent aneurysms in the disease.

No MeSH data available.


Related in: MedlinePlus