title: Extensive coronary aneurysms with thrombosis in resistant Kawasaki disease.
abstract: Giant coronary artery aneurysms that occur in 0.5 to 1% of patients with Kawasaki disease can be fatal if associated with thrombosis. Some patients may show persistent inflammation and fever despite treatment with repeated doses of intravenous immunoglobulin (IVIG), steroids, and aspirin. This report describes an infant boy with resistant Kawasaki disease who presented with extensive coronary artery involvement and coronary thrombosis. His inflammation was not controlled with multiple doses of IVIG, parenteral and oral steroids, or high-dose aspirin, and he finally needed infliximab, a monoclonal antibody against tumor necrosis factor alpha. The progression of coronary thrombosis was arrested by the platelet glycoprotein 2b/3a receptor blocker, abciximab, during the acute phase of the disease.
authors.affiliation: Department of Pediatric Cardiology, MIOT Hospital, 4/112, Mount Poonamalle Road, Chennai 600089, India. drkumarsiva@hotmail.com
authors.forename: Kothandam
authors.initials: K
authors.lastname: Sivakumar
authors.forename: Sreeja
authors.initials: S
authors.lastname: Pavithran
mesh_terms: D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004351:Drug Resistance; D004452:Echocardiography; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000188:drug therapy
chemical_list: D000893:Anti-Inflammatory Agents; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors