Akazawa Yusuke, Inaba Shinji, Sakaue Tomohisa, Kurata Mie, Aono Jun, Yasugi Takumi, Moritani Tomozo, Nishiyama Hikaru, Higaki Takashi, Eguchi Mariko, Yamaguchi Osamu
Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Department of Regional Pediatrics and Perinatology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
J Cardiol Cases. 2020 Nov 21;23(5):206-209. doi: 10.1016/j.jccase.2020.11.005. eCollection 2021 May.
The management of systemic artery aneurysms secondary to Kawasaki disease (KD) in adults remains a therapeutic challenge. KD guidelines recommend the use of anticoagulation therapy with warfarin in addition to antiplatelet therapy when a giant coronary aneurysm or a history of thrombosis is documented. However, long-term use of warfarin presents several concerns. This case reports acute thrombotic occlusion due to the giant arterial aneurysm in an adult KD. A surgical resection of the aneurysm was performed because of recurrent thrombotic events, despite anticoagulant therapy with warfarin. Pathological examinations revealed a layered thrombus with inflammation in the aneurysm and Factor Xa expression mainly in newly formed thrombus. This study provides an insight into the anticoagulation therapy for cardiovascular sequelae after KD. < This study, along with pathological evidence, illustrates that Factor Xa might contribute to thrombotic events after Kawasaki disease.>.
成人川崎病（KD）继发的系统性动脉瘤的管理仍然是一个治疗挑战。KD指南建议，当记录到巨大冠状动脉瘤或有血栓形成病史时，除抗血小板治疗外，还应使用华法林进行抗凝治疗。然而，长期使用华法林存在一些问题。本病例报告了一名成年KD患者因巨大动脉动脉瘤导致的急性血栓闭塞。尽管使用华法林进行了抗凝治疗，但由于反复出现血栓事件，仍对动脉瘤进行了手术切除。病理检查显示动脉瘤内有分层血栓伴炎症，且因子Xa主要表达于新形成的血栓中。本研究为KD后心血管后遗症的抗凝治疗提供了见解。<本研究与病理证据一起表明，因子Xa可能促成川崎病后的血栓形成事件。>
