Multiple Giant Succular and Fusiform Right and Left Coronary Artery Aneurysms after Early and Adequate Treatment of Atypical Kawasaki Disease with Unusual Presentation


The major complication of Kawasaki disease is coronary artery dilatation and aneurysm. It occurs in approximately 15-25% of untreated children with Kawasaki Disease. Early diagnosis and treatment with Intravenous immune globulin (IVIG) and aspirin (ASA) can reduce the incidence of coronary artery abnormality to 2%-5%. We report one case of Atypical Kawasaki Disease with Multiple giant coronary artery aneurysms despite early adequate treatment with IVIG and ASA.

Nakano H, Ueda k, Saito A, et al. Repeated quantitativeangiogram in coronary artery aneurysms in Kawasaki disease. Am J cardiol 1985:56(13):846-51.

Chanthong P, Sriyoschati S, Durongpisitkul K, et al. Coronary artery bay pass graft in Kawasaki disease patients: siriraj experience. J Med Assoc Thai 2005;88(Suppl 8):S197-202.

Brogan PA, Bose A, Burgner D, Shingadia Det al. Kawasaki disease: an evidence based approach to diagnosis, Treatment, and proposals for future research. Arch Dis Child 2002;86(4):286-90.

Freeman AF, Shulman ST. Kawasaki Disease: Summary of the American Heart Association Guidelines. Am Fam Physician 2006;74(7):11418.

Newburger JW, Takahashi M, Gerber MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004;110(17):274771.

Han RK, Sinclair B, Newman A, et al. Recognition and management of Kawasaki disease. CMAJ 2000;162(6):80712.

Klevberg S, Farstad T, Perminow KV. Incidence of Kawasaki disease. Tidsskr Nor Laegeforen 2004;124(13-14):1774-5.

Baroon KS. Kawasaki disease: Etiology, pathogenesis and treatment. Cleve Clin J Med 2002;69(Suppl 2):SII69-78.

Stockheim JA, Innocentini N, Shulman ST. Kawasaki disease in older children and adolescents. J Pediatr 2000;137(2):250-2.

Wong DML, Ng YM, Lee SH, Unusual presentation of Kawasaki Disease in an adolescent Male presenting with Hepatoremal Failure: case report. HK J Pediatr (New series) 2005;10(3):204-6.

Patil S, Shirodkar S, Pinto RJ, et al. Giant coronary artery aneurysms with a thrombus secondary to Kawasaki disease. Ann pediatr Cardiol 2008;1(1):59-61.

Kato H, Sugimura T, Akagi T, et al. Long-term consequences of Kawasaki disease: A 10-21 year followup 594 patients. Circulation 1996;94(6):1379-85.

Pannaraj PS, Turner CL, Bastian JF, et al. Failure todiagnosis Kawasaki disease at the extremes of the pediatric age range. Pediatr infect Dis J 2004;23(8):789-91.

Behjati-Ardakani M, Islami1 Z. Super Giant Coronary Aneurysm in Kawasaki Disease. Iran J Pediatr 2009;19(3):317-21.

Ha KS, Jang G, Lee J, et al. Incomplete clinica manifestation as a risk factor forcoronary artery abnormalities in Kawasaki disease: a meta-meta analysis. Eur J Pediatr 2013;172(3):343-9.

Ghelani SJ, Sable C, Wiedermann BL, et al. Increased Incidence of Incomplete Kawasaki disease at a pediatric Hospital after publication of the 2004 American Heart Association Guidelines. Pediatr Cardiol 2012;33(7):1097- 103.

Song D, Yeo Y, Ha K, et al. Risk factors for Kawasaki disease - associated coronary abnormalities differ depending on age. Eur J pediatr 2009;188(11):1315-21.

Oechslin EC, Arbenz U, Mayer K. Giant and fusiform aneurysms of coronary arteries following early and adequate treatment of suspected Kawasaki disease. Heart 2004;90(12):1437-9.

Khositseth A, Siripornpitak S, Pornkul R, et al. Case report: Giant coronary aneurysms caused by Kawasaki disease: follow up with echocardiography and multidetector CT angiography. BJ Radiol 2008;81(964):e106-9.

Atik E. Kawasaki disease: giant coronary arteries aneurysms regression and later stenosis. Arq Bras Cardiol 2007;88(1):e22-3.

IssueVol 52, No 6 (2014) QRcode
Kawasaki disease Giant coronary aneurysm Atypical manifestation Adolescent

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Behjati-Ardakani M, Ferdosian F. Multiple Giant Succular and Fusiform Right and Left Coronary Artery Aneurysms after Early and Adequate Treatment of Atypical Kawasaki Disease with Unusual Presentation. Acta Med Iran. 1;52(6):490-492.