A case of relapsing Kawasaki disease and review of the literature.
A review of the literature was carried out on the occasion of one case of Kawasaki disease in a small infant aged 3 months which relapsed 17 years later. Kawasaki disease is of unknown aetiology and mainly affects children under 5 years of age. It is manifested as a necrotizing vasculitis with aneurysms of the coronary arteries and the proximal medium size arteries. One hundred and fifteen thousand cases have been reported up to the present date, an incidence of 6-11/100,000 children. The evidence of coronary aneurysms range from 20-30%, while peripheral aneurysms are rare. Eighteen cases of peripheral ischemia have been reported in the international literature. The diagnosis is clinical and treatment remains symptomatic (anti-inflammatory and anticoagulant). Thrombolytic and anticoagulant management is applied in acute heart attack, and surgical bypass in chronic ischemia. Reversion of the aneurysms is observed in 60% of the cases, while relapse of the disease is possible years or decades later. Death is due to thrombosis of the coronary or rupture of the coronary or distal aneurysm. For this reason, regular fellow-up of the patients is recommended, according to the guidelines for long-term management of patients with Kawasaki disease.
Dimakakos
P
P
Areteion Hospital, Department of Vascular Surgery, Medical School, University of Athens.
Bredakis
J
J
Papageorgiou
A
A
Papasava
M
M
D000293:Adolescent; D003952:Diagnostic Imaging; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000628:therapy; D012008:Recurrence