Two Cases of New Coronary Aneurysms That Developed in the Late Period After Kawasaki Disease

2012 ◽  
Vol 34 (8) ◽  
pp. 1992-1995 ◽  
Author(s):  
Junichi Ozawa ◽  
Hiroshi Suzuki ◽  
Satoshi Hasegawa ◽  
Fujito Numano ◽  
Hisanori Haniu ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Late Period ◽  
Coronary Aneurysms

Variation in the management of Kawasaki disease

2019 ◽  
Vol 105 (10) ◽  
pp. 1004-1006 ◽  
Author(s):  
Audrey Dionne ◽  
David Burgner ◽  
Sarah De Ferranti ◽  
Davinder Singh-Grewal ◽  
Jane Newburger ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Initial Treatment ◽  
Coronary Aneurysm ◽  
Medical Specialty ◽  
Primary Treatment ◽  
Management Options ◽  
Necrosis Factor Alpha ◽  
Coronary Aneurysms ◽  
Factor Alpha ◽  
Collaborative Efforts

Intravenous immunoglobulin (IVIG) reduces coronary aneurysms in patients with Kawasaki disease (KD), but additional management options remain challenging, with no generalisable evidence-based recommendations. We performed a survey of 724 physicians from 73 countries to assess variation in practice. IVIG was the preferred initial treatment by 659 (91%) of respondents. Criteria for adjunctive primary treatment varied considerably and definitions of IVIG resistance varied markedly by geographical continent, Human Development Index tiers and medical specialty. A second dose of IVIG was used most often for patients with coronary aneurysm non-responsive to initial treatment (572, 79%), but corticosteroids (379, 52%) and tumour necrosis factor alpha inhibitors (208, 29%) were also frequently used. Our findings highlight the need for international collaborative efforts to optimise management of patients with KD worldwide.

Kawasaki disease complicated by cerebral infarction

2003 ◽  
Vol 13 (1) ◽  
pp. 103-105 ◽  
Author(s):  
Kenji Suda ◽  
Masahiko Matsumura ◽  
Shigeru Ohta
Keyword(s):  
Kawasaki Disease ◽  
Cerebral Infarction ◽  
Clinical Situation ◽  
Sudden Onset ◽  
X Ray ◽  
Coronary Aneurysms ◽  
Intracoronary Thrombolysis ◽  
Tissue Plasminogen ◽  
X Ray Computed ◽  
The Right

An 8-month-old boy presented with right hemiplegia of sudden onset after 20 days of Kawasaki disease, which was not initially treated by gamma globulin. Cranial X-ray computed tomography confirmed cerebral infarction as the cause of the right hemiplegia. In subsequent weeks, he developed multiple thromboses in coronary aneurysms. He successfully underwent intracoronary thrombolysis using tissue plasminogen activator without haemorrhagic complications. Cerebral infarction as a complication of Kawasaki disease is rare, and is a difficult clinical situation to manage.

Follow-up duration of echocardiography in patients with Kawasaki disease with no initial coronary aneurysms

2021 ◽  
Author(s):  
Qianzhi Wang ◽  
Yoshihiko Morikawa ◽  
Shogo Akahoshi ◽  
Koichi Miyata ◽  
Hiroshi Sakakibara ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Coronary Aneurysms

Abstract 212: Acute Myocardial Infarction in the Acute Phase in Kawasaki Disease in Mexican Children.

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
William Sarmiento-Robles ◽  
Luis M Garrido-Garcia
Keyword(s):  
Myocardial Infarction ◽  
Kawasaki Disease ◽  
Acute Phase ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Unknown Origin ◽  
Z Score ◽  
Laboratory Parameters ◽  
Small Series ◽  
Coronary Aneurysms

Background: Kawasaki disease (KD) is an acute febrile vasculitis of unknown origin. Despite treatment with intravenous immunoglobulin during the acute phase of the disease, up to 5% of those affected will develop coronary aneurysms predisposing them to thrombotic complications that could result in myocardial infarction (AMI). In Mexico there are few reports of ischemic complications secondary to KD. Objective: To describe the clinical features, the laboratory parameters, treatment used and the outcome of children who presented with myocardial infarction during the acute phase of KD in a third level facility in Mexico City Methods: From our Institutional Database of KD we search for children who presented AMI in the acute phase of the disease from August 1995 to August 2014. We analyzed gender, age, clinical manifestations, time from the onset of the symptoms to diagnosis, laboratory parameters, treatment used, and outcome in the acute phase of the disease. Results: Eight infants were diagnosed with AMI during the study period. The median age at diagnosis was 8 months (range 2 to 53 months). Seven patients were male (87.5%). The median from the onset of the clinical manifestations to diagnosis of KD was 22 days (range 4 to 26 days). All patients developed giant coronary aneurysms (median Z-score 18.98, with a range of Z-score from 11.58 - 27.70). An abnormal EKG and abnormal perfusion tests demonstrated the myocardial infarction in all cases. Two patients died in the acute phase of cardiogenic shock, one more patient died of dilated cardiomyopathy 12 months after coronary bypass surgery with an overall mortality of 62.5% of this group. Conclusions: AMI is a fatal complication of KD. In our small series it was associated with a delayed diagnosis of the disease and therefore the development of giant coronary aneurysms. Treatment of AMI in children after KD is a medical challenge with a poor prognosis in children.

Incidence of coronary aneurysms in children with Kawasaki disease after early treatment with IVIG and aspirin: Report of 55 cases

2013 ◽  
Vol 42 (4) ◽  
pp. 771
Author(s):  
C. Romero ◽  
C. Perez ◽  
P. Martinez ◽  
R. Urabayen ◽  
P. Fanlo ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Early Treatment ◽  
Coronary Aneurysms

scholarly journals Risk factors for the occurrence and persistence of coronary aneurysms in Kawasaki disease

2019 ◽  
Vol 62 (4) ◽  
pp. 138-143 ◽  
Author(s):  
Soo-kyeong Jeon ◽  
Geena Kim ◽  
Hoon Ko ◽  
Joung-Hee Byun ◽  
Hyoung Doo Lee
Keyword(s):  
Risk Factors ◽  
Kawasaki Disease ◽  
Coronary Aneurysms

scholarly journals Resistant kawasaki disease in an infant causing giant coronary aneurysms with thrombosis

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Ayad Anass ◽  
Hasbaoui Brahim ◽  
Sghir Salah ◽  
Yajouri Abdelhakim ◽  
Abilkassem Rachid ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Coronary Aneurysms

Does Abciximab Enhance Regression of Coronary Aneurysms Resulting From Kawasaki Disease?

PEDIATRICS ◽  
2002 ◽  
Vol 109 (1) ◽  
pp. e4-e4 ◽  
Author(s):  
R. V. Williams ◽  
V. M. Wilke ◽  
L. Y. Tani ◽  
L. L. Minich
Keyword(s):  
Kawasaki Disease ◽  
Coronary Aneurysms

Abstract 219: Long - Term Prognosis Of Patients With Kawasaki Disease Complicated By Significant Coronary Aneurysm (diameter ≥ 6 mm)

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Ji Seok Bang ◽  
Gi Beom Kim ◽  
Bo Sang Kwon ◽  
Eun Jung Bae ◽  
Chung Il Noh ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Coronary Aneurysm ◽  
Coronary Intervention ◽  
Surgical Interventions ◽  
Coronary Aneurysms ◽  
The Mean

Background: Some patients with Kawasaki disease (KD) develop large coronary aneurysms (diameter ≥ 6mm) and coronary stenosis, leading to ischemic heart disease. This study determined the long-term outcome for patients with Kawasaki disease complicated by significant coronary aneurysm. Methods and Results: From the database in Seoul National University Children’s Hospital between December 1986 and December 2013, medical records of 83 patients (61 men and 22 women) with large coronary aneurysms (diameter ≥ 6mm) were retrospectively reviewed. Information on patient demographics, catheter or surgical interventions, and most recent status was collected. From these data, we calculated the survival rate, cumulative coronary intervention rate, coronary artery bypass graft surgery rate. The mean age at onset was 4.28 ± 2.62 years, and the mean observational period was 13.2 ± 6.5 years. The maximum coronary artery internal diameter ranged from 6.1 to 25mm (median 9mm). Giant coronary aneurysm was 57 patients (68.7%) and large coronary aneurysm (6-8mm) was 26 patients (31.3%). Coronary aneurysms had progressed to coronary artery stenosis and/or complete occlusion in 42 patients (50.6%). The overall freedom from coronary intervention, coronary artery bypass surgery, or coronary thrombi was respectively 85.5%, 85.5%, and 90.3%. Catheter and surgical coronary interventions (median 1 intervention; range 1 to 5 interventions) were performed in 20 patients (24.1%) at 9 month to 18 years after onset, resulting in 33.7% cumulative coronary intervention rates at 20 years after onset. There were no differences in cumulative coronary intervention rates between two coronary aneurysm groups (6-8mm vs ≥8mm). Myocardial infarction occurred in 8 (8.98 %) patients. During this study period, 1 patient died and 98% survival rates was seen in our patients group. Conclusion: The long-term survival of patients with Kawasaki disease complicated by large coronary aneurysm is good even though a fourth of patients underwent multiple catheter or surgical interventions. Further research should focus on the indications for and effectiveness of percutaneous and surgical coronary interventions in large coronary aneurysm (≥ 6mm).

Abstract 2764: The Advantages of using Multi-slice Spiral Computed Tomography to Evaluate Serious Coronary Complications in Adolescents after Kawasaki Disease

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Hiroshi Kanamaru ◽  
Kensuke Karasawa ◽  
Rie Ichikawa ◽  
Osamu Abe ◽  
Michio Miyashita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Kawasaki Disease ◽  
Coronary Calcification ◽  
Spiral Computed Tomography ◽  
Spiral Computed ◽  
Main Trunk ◽  
Diagnostic Modality ◽  
Stenotic Lesion ◽  
Coronary Aneurysms ◽  
Stenotic Lesions

Objectives We identified novel multi-slice spiral computed tomography (MSCT) findings in adolescents after Kawasaki disease that could not be detected by coronary angiography (CAG). Methods We studied 18 patients who had suffered from serious coronary arterial lesions after Kawasaki disease (mean age: 21.7 years; range: 13 to 34 years). Seventeen patients had stenotic lesions, and all had coronary aneurysms. MSCT was performed using a Siemens SOMATOM Volume Zoom (4-detector row) or a Toshiba Aquillion 16 (16-detector row). The detection of coronary calcification, stenotic lesion, and intimal hypertrophy was applied to all coronary arteries in MSCT and compared to CAG. Results Of the 18 patients, there were 11 (61%) in whom novel findings were detected by MSCT. Coronary calcifications were found in 11 of the 18 patients (61%) by MSCT. Five patients had concentric calcified aneurysms, 4 had eccentric calcified aneurysms, and the other 2 had mixed calcified aneurysms. Coronary stenotic lesions were present in 6 of the 18 patients (33%) with calcified aneurysms. There were 2 patients who had intimal hypertrophy (11%). One patient had intimal hypertrophy along the left main trunk with a giant calcified aneurysm along the left anterior descending artery. Two patients had severe stenoses just distal to giant calcified aneurysms that were regarded as false positive findings, which were identified as mild stenoses by CAG. Conclusions MSCT offers advantages over CAG in the evaluation of calcified aneurysms and intimal hypertrophy, and has the potential to become a diagnostic modality for coronary intervention in adolescents after Kawasaki disease.

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