Bilateral Giant Coronary Aneurysms in Kawasaki Disease

• DOI: 10.1161/circulationaha.113.002092
• Publication Date: 2013-11-11T21:25:21Z
• Authors: Sergej Prijic; Goran Ristic; Srdjan Pasic; Aleksandra Minic; Vladislav Vukoman...; Oto Adjic; Sanja Ninic; Jovan Kosutic
• Keywords: Male; Coronary Aneurysm; Mucocutaneous Lymph Node Syndrome; Magnetic Resonance Imaging; Multimodal Imaging; Severity of Illness Index; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Echocardiography; Child, Preschool; Acute Disease; Humans

We report on a 4-year-old boy admitted to our Institute because of fever (39°C) persisting for 8 days. Physical examination showed bilateral conjunctivitis, strawberry tongue, lip fissures, enlarged cervical lymph nodes, and polymorphous rash, followed by finger and toe desquamation (see Figure I in the online-only Data Supplement). Diagnosis of Kawasaki disease was made. According to the Kobayashi risk score, our patient had 8 points, predicting treatment unresponsiveness of 71.4%.1 Over the next 2 weeks, the symptoms of acute phase persisted despite treatment with intravenous immunoglobulin, as well as retreatment with intravenous immunoglobulin and methyl-prednisolone boluses. In week 4 of the disease, he was given infliximab in a single dose of 5 mg/kg. He became afebrile, and his inflammatory parameters normalized after treatment with infliximab. An initial echocardiography examination performed immediately after the admission showed no specific changes. The second echocardiographic …