title: [Kawasaki's disease in remission with cardiac involvement: intrasacular thrombus in a giant aneurism of both coronary arteries. Case report].
abstract: Kawasaki disease is of relevance in pediatric practice because it is a systemic vasculitis of unknown origin and the most common cause of acquired heart disease in young patients. Its main complication is the formation of a coronary aneurysm in 25% of patients, unless they receive timely medical treatment. We report the case of a 4 month old male child with Kawasaki's disease, received treatment with gammaglobulin and acetyl-salicylic acid, in which the initial echocardiogram showed aneurysms. Admitted to our hospital with cardiogenic shock, we documented by echocardiography the presence of coronary aneurysms with intra-saccular thrombus and acute myocardial infarction. He received fibrinolytic therapy, with an adequate response: the size of aneurysms decreased, as did the intra-saccular thrombus. Currently the patient is asymptomatic and receiving treatment with warfarin and acetylsalicylic acid. The diagnosis and treatment, as well as identification of risk factors can prevent fatal complications at the cardiovascular level. The treatment in the first 10 days of illness with gammaglobulin and acetyl-salicylic acid reduced cardiac complications from 4.7 to 25%.
authors.affiliation: Residente de 2.° año de Reumatología Pediátrica, Hospital Infantil de México, México DF, México. karlamendiola@hotmail.com
authors.forename: Karla
authors.initials: K
authors.lastname: Mendiola Ramírez
authors.forename: Jorge Omar
authors.initials: JO
authors.lastname: Osorio Díaz
authors.forename: María del Rocío
authors.initials: Mdel R
authors.lastname: Maldonado Velázquez
authors.forename: Enrique
authors.initials: E
authors.lastname: Faugier Fuentes
mesh_terms: D003323:Coronary Aneurysm / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology*; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology*