Bachiri A, Francart C, Godart F, Brevière G M, Vaksman G, Martinot V, Rey C
Service de cardiologie infantile, hôpital cardiologique, hôpital Roger-Salengro, boulevard du Professeur-Leclerq, 59037 Lille, France.
Arch Pediatr. 2000 Dec;7(12):1307-10. doi: 10.1016/s0929-693x(00)00148-2.
An aneurysm of the medium arteries is one of the major complications of Kawasaki syndrome. Eleven cases of giant coronary aneurysm have been reported.
We report a new case in a nine-month-old child. Ischemia of the left hand was the first symptom. Diagnosis was made 30 days later. Anticoagulant and fibrinolytic treatments did not prevent necrosis of four fingers.
The prognosis of Kawasaki disease depends on early diagnosis and management. Infants younger than seven months of age are more susceptible to developing coronary and midartery aneurysms, which therefore justifies a close observation during the acute phase and later on. In the case of a coronary artery aneurysm, Doppler echography of the upper and lower limbs is mandatorily recommended. Anticoagulant therapy should be started once the diagnosis of mid-artery aneurysms is made. Ischemia of the extremities can lead to necrosis and amputation. Until now, anticoagulants, vasodilators and fibrinolytic agents were not proven to be effective.
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