All issues > Volume 46(3); 2003

Case Report

J Korean Pediatr Soc. 2003;46(3):302-307. Published online March 15, 2003.

Thrombolytic Therapy and Long Term Follow-up Study in a Child with Kawasaki Disease Complicated by Giant Coronary Aneurysm with Thrombosis

Su Jung SJ Moon¹, Su Ya SY Lee¹, Kyong Hee KH Na¹, Sun Young SY Park¹, Eun Young EY Kim¹, Kyoung Sim KS Kim¹, Yong Wook YW Kim¹

Correspondence Yong Wook YW Kim ,Email: KYW528@chollian.net

Abstract

The long-term clinical issues in Kawasaki disease are concerned with the coronary artery lesions that result in aneurysmal formation, thrombotic occlusion, progression to ischemic heart disease, and premature atherosclerosis. We here report a 3 month old infant with Kawasaki disease complicated by giant coronary aneurysm with thrombosis. After urokinase(10,000 IU/kg) and heparin(400 IU/kg) were injected for two days as thrombolytic agents, thrombi were successfully dissolved. Even though long-term oral anticoagulation with low-dose aspirin, dipyridamole and coumadin were administered, thrombosis of the left main coronary artery was slowly increased. five years later, coronary angiography showed nearly total occlusion of the left anterior descending artery and collaterals from the right posterior branch and radionuclide scan demonstrated complete reversible perfusion defect of several portions of the left ventricle.

Keywords :Kawasaki disease, Thrombosis, Giant aneurysms, Thrombolytic agents, Coronary arteries, Occlusion