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

Korean Journal of Pediatrics 2005;48(8):901-906.
Published online August 15, 2005.
Giant Coronary and Axillary Aneurysms in an Infant with Kawasaki Disease Associated with Thrombocytopenia
Sei Young Seo, Jin Hee Oh, Jong-Hyun Kim, Ji-Whan Han, Kyung-Yil Lee, Dae Kyun Koh
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
혈소판 감소증이 지속된 영아 가와사끼병 환아에서 발생한 거대관상동맥류와 액와동맥류
서세영, 오진희, 김종현, 한지환, 이정일, 고대균
가톨릭대학교 의과대학 소아과학교실
Jin Hee Oh, Email: Jeany@catholic.ac.kr
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.
Key Words: Mucocutaneous lymph node syndrome , Infant , Thrombocytopenia , Coronary aneurysm , Axillary aneurysm

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