Micallef Eynaud S, Attard Montalto S, Grech V
Department of Paediatrics, Mater Dei Hospital , Malta.
Images Paediatr Cardiol. 2016 Jul-Sep;18(3):9-15.
Kawasaki disease (KD) is an acute febrile, systemic vasculitic syndrome of unknown etiology, occurring primarily in children younger than 5 years of age. Administration of IVIG within the first 10 days after onset of fever in combination with high dose aspirin reduces the risk of coronary artery damage in KD. Though rare, giant aneurysms of the coronary arteries may develop in untreated cases and prove extremely challenging to manage.
A 9-month-old Caucasian boy presented to our paediatric emergency department with a 4-week history of intermittent pyrexia and irritability. Typical mucocutaneous signs of Kawasaki Disease were absent upon presentation. A trans-thoracic echocardiogram identified a giant aneurysm of the left anterior descending artery with thrombus formation in-situ and the child was managed with intravenous immunoglobulin, steroids, high dose aspirin therapy and later warfarinisation.
Cardiovascular sequelae of Kawasaki disease include giant coronary artery aneurysms with thrombosis. Enlargement of a coronary aneurysm after the acute phase of Kawasaki disease is uncommon and the outcome of interventional approaches poorly studied.
川崎病（KD）是一种病因不明的急性发热性全身性血管炎综合征，主要发生在5岁以下儿童。发热开始后10天内静脉注射免疫球蛋白（IVIG）联合大剂量阿司匹林可降低KD患儿冠状动脉损伤的风险。尽管罕见，但未经治疗的病例可能会出现冠状动脉巨大动脉瘤，治疗极具挑战性。
一名9个月大的白种男孩因间歇性发热和易怒4周就诊于我院儿科急诊科。就诊时未出现川崎病典型的黏膜皮肤症状。经胸超声心动图发现左前降支动脉巨大动脉瘤并原位血栓形成，该患儿接受了静脉注射免疫球蛋白、类固醇、大剂量阿司匹林治疗，随后进行了华法林抗凝治疗。
川崎病的心血管后遗症包括冠状动脉巨大动脉瘤伴血栓形成。川崎病急性期后冠状动脉瘤增大并不常见，介入治疗的效果研究较少。
