Abstract
We present a rare association of Kawasaki disease in a two year old boy presenting with fever, a morbiliform rash and clinical signs of intestinal pseudo-obstruction. Our patient subsequently developed a giant aneurysm of the right coronary artery complicated with thrombosis. He presented fever again 48 hours after the first dose of Immunoglobulin andneeded a second one with good results. These patients with giant coronary aneurysms have a greater risk of developing stenosis and myocardial infarction, and require anticoagulant therapy, frequent stress scans and coronary angiographies. Those who developed less severedisease need only antiplatelet therapy and less frequent cardiovascular tests. Patients with a normal echocardiogram after the acute phase of the disease are not treated. The long-term prognosis of this disease is uncertain, especially regarding the possible association with coronary disease in adult life.
Highlights
We present a rare association of Kawasaki disease in a two year old boy presenting with fever, a morbiliform rash and clinical signs of intestinal pseudo-obstruction
Our patient subsequently developed a giant aneurysm of the right coronary artery complicated with thrombosis
He presented fever again 48 hours after the first dose of Immunoglobulin and needed a second one with good results. These patients with giant coronary aneurysms have a greater risk of developing stenosis and myocardial infarction, and require anticoagulant therapy, frequent stress scans and coronary angiographies
Summary
Presentamos a un paciente varón de dos años de edad con Enfermedad de Kawasaki y secuelas cardiovasculares. El desarrollo de aneurismas coronarios puede ocurrir en el 20 a 25% de pacientes no tratados o tratados tardíamente (8 días después del inicio de la enfermedad) con immunoglobulina, cifra que disminuye hasta un 2 a 4% en aquellos tratados oportunamente (20).
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