Korean J Pediatr.  2005 Aug;48(8):901-906.

Giant Coronary and Axillary Aneurysms in an Infant with Kawasaki Disease Associated with Thrombocytopenia

• Seo SY
• Oh JH
• Kim JH
• Han JW
• Lee KY
• Koh DK

Abstract

Kawasaki disease (KD) is a leading cause of acquired heart disease in children. Yet the etiology of KD is still unknown and diagnosis depends on the exclusion of other diseases and the clinical manifestations meeting the defined criteria. Young infants frequently show atypical clinical courses and are frequently complicated with coronary aneurysms. Some cases show thrombocytopenia, which is known as one of the risk factors for complications with coronary aneurysms. So, a high index of suspicion is the most important factor for the diagnosis of KD in very young infants or adolescents whose clinical courses are equivocal. We report herein on a case of KD in an 80-day-old female infant with fever and seizure with bloody stool; laboratory findings were those of sepsis with disseminated intravascular coagulopathy. In spite of aggressive treatments, fever and thrombocytopenia persisted for two weeks and huge coronary aneurysms developed at the third week in all three major coronary arteries; the diameter of the right one was as large as the aortic annulus. Three months later, huge pulsatile masses developed in both axillas; these were found to be huge axillary aneurysms defined very clearly on multi-detector CT scan. She has been under follow up with antiplatelets and anticoagulation therapy with poor regression of the aneurysms.

Keyword

Mucocutaneous lymph node syndrome; Infant; Thrombocytopenia; Coronary aneurysm; Axillary aneurysm

MeSH Terms

Adolescent
Aneurysm*
Axilla
Child
Coronary Aneurysm
Coronary Vessels
Diagnosis
Female
Fever
Follow-Up Studies
Heart Diseases
Humans
Infant*
Mucocutaneous Lymph Node Syndrome*
Risk Factors
Seizures
Sepsis
Thrombocytopenia*
Tomography, X-Ray Computed