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.

scholarly journals Low-Dosed X-Ray Computed Tomography Imaging by Regularized Fully Spatial Fractional-Order Perona-Malik Diffusion

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Zhiwu Liao
Keyword(s):  
Computed Tomography ◽  
Fractional Order ◽  
Low Dose ◽  
Computed Tomography Imaging ◽  
Edge Preserving ◽  
X Ray ◽  
Good Ability ◽  
X Ray Computed ◽  
The Right ◽  
Low Dose Computed Tomography

Existing fractional-order Perona-Malik Diffusion (FOPMD) algorithms used in noise suppressing suffer from undesired artifacts and speckle effect, which hamper FOPMD used in low-dosed X-ray computed tomography (LDCT) imaging. In this paper, we propose a new FOPMD method for low-dose computed tomography (LDCT) imaging, which is called regularized fully spatial FOPMD (RFS-FOPMD), whose numerical scheme is also given based on Grünwald-Letnikov derivative (G-L derivative). Here, fully spatial FOPMD represents all the integer-order derivatives (IODs) in the right hand of Perona-Malik Diffusion (PMD) which are replaced by fractional-order derivatives (FODs). Since the new scheme has advantages of both regularization and FOPMD, it has good abilities in singularities preserving while suppressing noise. Some real sinogram of LDCT are used to compare the different performances not only for some classical but also for some state-of-art diffusion schemes. These schemes include PMD, regularized PMD (RPMD), and FOPMD in (Hu et al. 2012). Experimental results show that besides good ability in edge preserving, the new scheme also has good stability for iteration number and can avoid artifacts and speckle effect with suitable parameters.

Abstract O.74: Statin Alleviates Persistent Coronary Arterial Inflammation Long After Kawasaki Disease - A Serial Fluorodeoxyglucose Positron Emission Tomography Study -

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Kenji Suda ◽  
Nobuhiro Tahara ◽  
Akihiro Honda ◽  
Hironaga Yoshimoto ◽  
Shintaro Kishimoto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Fdg Pet ◽  
Emission Tomography ◽  
X Ray ◽  
Background Ratio ◽  
Positron Emission ◽  
X Ray Computed

The patient, 42-year-old male, was suffered from Kawasaki disease (KD) at 4 month of age and left with giant left coronary artery aneurysm (CAA) and occluded giant right CAA. When he visited us at 40 years of age after long interval, a multi-detector X-ray computed tomography revealed persistent giant CAA with 12 mm in diameter at segment 6 with low density area inside of it, stenosis distal to this CAA, persistent giant CAA with 12 mm in diameter at segment 11, and total occlusion of right coronary artery orifice with recanalization. Positron emission tomography using fluorodexoy glucose (FDG-PET) with co-registration of x-ray computed tomography showed significant FDG uptake around the left coronary orifice of the aortic wall and extending to the proximal left CAA wall with 1.48 of target-to-background ratio, indicating persistent inflammation. He has 2 risk factors of atherosclerosis, dyslipidemia and a history of smoking and, since then he has been placed on 2 mg of oral pitavastatin. With the treatment, his LDL-cholesterol has decreased (105 at baseline vs. 74 mg/dL on treatment) though HDL-cholesterol did not change significantly (31 at baseline vs. 30 mg/dl on treatment). FDG-PET after 2 years of treatment indeed showed alleviation of coronary inflammation with significantly smaller area and lower uptake of FDG on the coronary wall with 1.28 of target-to-background ratio. This case indicates that statin can alleviate persistent coronary artery inflammation long after KD and FDG-PET can be a useful monitoring tool of this process.

scholarly journals Recurrent Kawasaki Disease: A Case Report of Three Separate Episodes at >4-Year Intervals

Children ◽  
2018 ◽  
Vol 5 (11) ◽  
pp. 155 ◽  
Author(s):  
Nikita Goswami ◽  
Katherine Marzan ◽  
Elizabeth De Oliveira ◽  
Sharon Wagner-Lees ◽  
Jacqueline Szmuszkovicz
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Systemic Vasculitis ◽  
High Dose ◽  
Z Score ◽  
Coronary Aneurysms ◽  
Increased Risk ◽  
The Right ◽  
Work Up ◽  
High Dose Aspirin

Kawasaki disease (KD) is a self-limited systemic vasculitis, most often occurring in children 1–5 years old. It has a 2% recurrence rate and is associated with coronary aneurysms (CA), which can develop within two weeks of onset. A 25% increased risk is noted in patients who are recalcitrant to treatment. We describe a patient with recurrence of KD three times, approximately four years apart. A 10-year-old female with two previous episodes of KD, at 11 months and five years of age), in which she met five out of five criteria for KD and had no coronary involvement, presented with 15 days of fever, conjunctivitis and mucocutaneous changes. Infectious work-up was negative, and she was diagnosed with incomplete KD meeting three out of five criteria. An echocardiogram (ECHO) on day 12 revealed dilation of the right coronary artery (RCA) and left coronary artery (LCA). Treatment with intravenous immunoglobulin (IVIG) and high-dose aspirin was started at an outside hospital. After transfer, serial ECHOs showed evolving coronary aneurysms, left anterior descending (LAD) z-score + 8.2 and RCA z-score + 4.0. She received 10 mg/kg infliximab (day 18) and began clopidogrel. A cardiac MRI (day 20) demonstrated progression of the LAD aneurysm, with a z-score + 13, and warfarin was started. To our knowledge, this is the first report of recurrent KD occurring three times at ~5 year intervals.

scholarly journals Kawasaki Disease Complicated by Late-Onset Fatal Cerebral Infarction: A Case Report and Literature Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Lin Wang ◽  
Hongyu Duan ◽  
Kaiyu Zhou ◽  
Yimin Hua ◽  
Xiaoliang Liu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Cerebral Infarction ◽  
Basal Ganglion ◽  
Cerebral Artery ◽  
Late Onset ◽  
Anticoagulation Therapy ◽  
Cardiac Complications ◽  
Intravenous Immunoglobulin Therapy ◽  
The Right

Background: Cerebral infarction is a rare neurological complication of Kawasaki disease (KD) and occurs in the acute or subacute stage. There have been no reported cases of late-onset fatal cerebral infarction presenting over 1 year after the onset of KD.Case Presentation: A 5-month-old male patient with KD received timely intravenous immunoglobulin therapy; however, extensive coronary artery aneurysms (CAA) and coronary artery thrombosis (CAT) developed 1 month later. Anticoagulation and thrombolytic agents were suggested, but the child's parents refused. Fifteen months after KD onset, an attack of syncope left him with left hemiplegia; brain computerized tomography (CT) scans revealed cerebral infarction of the right basal ganglion without hemorrhage. Magnetic resonance angiography (MRA) revealed severe stenosis of the right middle cerebral artery, and a series of tests were performed to exclude other causes of cerebral infarction. Considering the cerebral infarction and CAT, combination therapy with urokinase and low-molecular-weight heparin (LMWH) was initiated within 24 h of syncope onset, together with oral aspirin and clopidogrel. Five days later, his clinical symptoms partially regressed and he was discharged. Unfortunately, 5 days after discharge, his clinical condition suddenly deteriorated. Repeat brain CT showed hemorrhagic stroke involving the entire left cerebral area, in addition to the previous cerebral infarction in the right basal ganglion, with obvious secondary cerebral swelling and edema, which might have been caused by previous thrombolysis. Severe cerebral hernias developed quickly. Regrettably, the patient's parents abandoned treatment because of economic factors and unfavorable prognosis, and he died soon after.Conclusions: Cerebral infarction and cerebral artery stenosis can develop late, even 1 year after the onset of KD. Pediatricians should be aware of the possibility of cerebrovascular involvement in addition to cardiac complications during long-term follow-up of KD patients. Prompt anticoagulation therapy and regular neuroimaging evaluation are essential for the management of patients with KD with giant CAA and/or CAT.

scholarly journals Calcified cephalohemtoma: A case report: تكلس رأس الدم الدموي

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Maryam Mohamed Ali, Abdalla Mohamed Etbiga
Keyword(s):  
Suture Line ◽  
Blood Products ◽  
Birth Injury ◽  
Benign Condition ◽  
X Ray ◽  
Live Births ◽  
Subgaleal Hematoma ◽  
X Ray Computed ◽  
Fluid Collections ◽  
The Right

    Cephalohaematomas are traumatic subperiosteal hematomas of the skull that are usually caused by birth injury. They are bound between the periosteum and cranium, and therefore cannot cross sutures. Being bound by a suture line distinguishes them from subgaleal hematoma, which can cross sutures. Cephalohematomas occur in 1-2% of live births. The incidence increases with ventouse and forceps extraction and thus more common in primiparous mothers. There may be a greater male predilection. Cephalohaematomas are clinically diagnosed and infrequently imaged. They can be unilateral or bilateral, and appear as subgaleal fluid collections bounded by suture lines. In the setting of craniosynostosis, the blood products are able to traverse the affected suture. By 2-3 weeks, they may become peripherally calcified. The hematoma usually resolves in 2-3 months. Most resolve spontaneously. Cephalohaematomas usually gradually incorporate into the calvaria by ossification. This report describes a Libyan infant of two months of age, presented with a hard-globular swelling over the right parietal region. The child was delivered via vaginal delivery, it was a difficult delivery, at birth the cephalohemtoma was noted. The swelling was initially soft but later became hard. A suspicion that calcified cephalhematoma could present in such a manner supported by careful history taking and relevant imaging (X-ray/computed tomography) would help in appropriate evaluation of this benign condition.    

276 Management of Giant Coronary Artery Aneurysms as a Coronary Sequelae of Kawasaki Disease – Surgical or Conservative Management?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
F F Quek ◽  
R Tulloh
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Cardiac Mri ◽  
Previous History ◽  
Developed Countries ◽  
Strenuous Exercise ◽  
Coronary Perfusion ◽  
Best Interest ◽  
Coronary Aneurysms ◽  
The Right

Abstract Introduction Kawasaki Disease (KD) is the commonest childhood acquired heart disease in developed countries, predominantly affecting children younger than 5 years of age. These patients are at high risks of developing coronary arterial aneurysms (CAA) and CAA with absolute internal luminal diameters measuring ≥8mm or Z-score ≥10 is classified as giant coronary aneurysms (GCA). Case Report A 19-year-old girl with previous history of Kawasaki disease was diagnosed with giant coronary aneurysms on echocardiograms. Her subsequent CT coronary angiography showed large aneurysms in the right coronary artery (29mm x 25mm) and left anterior descending artery (10mm x 10mm) with signs of calcification. However, surprisingly, despite the evidence of large coronary aneurysms, she was completely asymptomatic and was physically active. Her cardiac MRI scan showed right coronary perfusion deficit in the distal right coronary territory but with no evidence of myocardial infarction. After having a detailed discussion in the MDT and with colleagues from San Diego, USA, a conservative approach was decided to be in the patient’s best interest. She has been advised to avoid competitive or strenuous exercise due to the associated risks. She is fit-and-well and is currently on Warfarin variable dose and Aspirin 75mg OD, with annual cardiac MRI surveillance.

scholarly journals Intrauterine Contraceptive Device Complication: Migration to the Small Bowl and Ovary Concurrently

2020 ◽  
Author(s):  
Mohammad Reza Sasani ◽  
Amir Hossein Soltani
Keyword(s):  
Rare Event ◽  
Intrauterine Contraceptive Device ◽  
Bowel Loop ◽  
Uterine Perforation ◽  
Contraceptive Device ◽  
X Ray ◽  
Intrauterine Contraceptive ◽  
X Ray Computed ◽  
The Right ◽  
Initial Method

Intrauterine Contraceptive Device (IUD) is a useful and reversible contraceptive method. This method has potential complications. Uterine perforation and IUD migration is rare but is a serious complication. Migrated IUD could situate in different organs such as bowel loop, urinary bladder, fallopian tube, or ovary. However, the presence of a displaced IUD simultaneously in the two organs is a rare event. Ultrasonography is an appropriate and initial method for evaluating the IUD location. Abdominopelvic x-ray, computed tomography, and MRI are adjunctive imaging modalities. We present a case with migrated IUD, which was located in the right ovary and small intestine simultaneously.

scholarly journals Incomplete Kawasaki Disease: What Can We Do About It?

2020 ◽  
Vol 25 (4) ◽  
pp. 57-59
Author(s):  
Luminiţa Dobrotă ◽  
Corina Cazan ◽  
Dan-Vladimir Bratu ◽  
Bogdan Neamţu
Keyword(s):  
Heart Disease ◽  
Kawasaki Disease ◽  
Inflammatory Process ◽  
Rare Condition ◽  
Incomplete Kawasaki Disease ◽  
Common Cause ◽  
Surgical Interventions ◽  
Coronary Aneurysms ◽  
Acquired Heart Disease ◽  
The Right

Abstract Kawasaki disease is a rare condition that mainly affects children younger than 6 years old. However, it represents the most common cause of acquired heart disease and the second most frequent vasculitis in children. Its importance consists in cardiac (coronary) complications identified in adults younger than 40 years old. Early diagnosis is pivotal for preventing (or reducing) coronary aneurysms and avoiding, at least, later unnecessary surgical interventions. Full (classic, complete) Kawasaki disease is easily diagnosed, even if the symptoms are not always present at the same time and most of them are unspecific. Incomplete Kawasaki disease implies challenge, delay or misdiagnosis. “Picking it up early is a winner” – the specialists say, so that early treatment administered at the right moment can stop the inflammatory process leading to much better outcomes, consequently.

scholarly journals Congenital agenesis of the lung: A case report and literature review

2017 ◽  
Vol 1 ◽  
pp. 12
Author(s):  
Rajesh Gupta ◽  
Anjali Gupta ◽  
Aradhana Singh
Keyword(s):  
Respiratory Distress ◽  
Sudden Onset ◽  
Age Group ◽  
X Ray ◽  
Adult Age ◽  
Foreign Body Bronchus ◽  
Group A ◽  
Congenital Agenesis ◽  
The Right

Developmental malformations of the lung are common but complete agenesis of the lung is quite rare and usually the patients presented are in early childhood; though according to literature, a few cases have come to light even in the adult age group. A 10-month-old male child presented with a sudden onset of respiratory distress with opacity of the right hemithorax on X-ray, raising suspicion of foreign body bronchus. Subsequent CT scans and bronchoscopy revealed agenesis of the right lung. Patient was managed conservatively and his parents were counseled about the anomaly. The child is doing well and is in a regular follow-up with us. Agenesis of the lung should be suspected in children with recurrent respiratory distress with opacity of the hemithorax on X-ray and herniation of the opposite lung across the mediastinum.

Low temperature x-ray microanalysis of frozen-hydrated tobacco leaves

1984 ◽  
Vol 42 ◽  
pp. 284-285
Author(s):  
S. Edith Taylor ◽  
Patrick Echlin ◽  
May McKoon ◽  
Thomas L. Hayes
Keyword(s):  
Low Temperature ◽  
Lemna Minor ◽  
Root Tips ◽  
Tobacco Leaves ◽  
X Ray ◽  
Whole Cells ◽  
Carbon Coated ◽  
The Right ◽  
Beam Currents ◽  
The University

Low temperature x-ray microanalysis (LTXM) of solid biological materials has been documented for Lemna minor L. root tips. This discussion will be limited to a demonstration of LTXM for measuring relative elemental distributions of P,S,Cl and K species within whole cells of tobacco leaves.Mature Wisconsin-38 tobacco was grown in the greenhouse at the University of California, Berkeley and picked daily from the mid-stalk position (leaf #9). The tissue was excised from the right of the mid rib and rapidly frozen in liquid nitrogen slush. It was then placed into an Amray biochamber and maintained at 103K. Fracture faces of the tissue were prepared and carbon-coated in the biochamber. The prepared sample was transferred from the biochamber to the Amray 1000A SEM equipped with a cold stage to maintain low temperatures at 103K. Analyses were performed using a tungsten source with accelerating voltages of 17.5 to 20 KV and beam currents from 1-2nA.

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