title: Coronary aneurysms in a child: an unusual presentation of pseudovasculitis.
abstract: Abnormalities of the coronary arteries in children are rare and Kawasaki disease is the most common cause of acquired coronary disease in a paediatric population. We report a case of a female child with coronary artery aneurysms and convulsions, who was diagnosed with Kawasaki disease. Due to systemic arterial hypertension and persistence of high inflammatory markers after treatment with high dose glucocorticoid and intravenous immunoglobulin, further investigation was performed and revealed a pheochromocytoma. Surgical removal led to normalization of blood pressure and laboratory parameters. Periodic echocardiography studies revealed progressive reduction of coronary aneurysms, with complete normalisation after 8 months. This is the first case described of coronary aneurysms presenting as a pseudovasculitis syndrome associated with pheochromocytoma.
authors.affiliation: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. lucianapc@gmail.com
authors.forename: Luciana P C
authors.initials: LP
authors.lastname: Seguro
authors.forename: Jozelio
authors.initials: J
authors.lastname: Freire de Carvalho
authors.forename: Alessandro C
authors.initials: AC
authors.lastname: Lianza
authors.forename: Rosa M R
authors.initials: RM
authors.lastname: Pereira
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000315:Adrenalectomy; D015415:Biomarkers / Q000097:blood; D002648:Child; D003323:Coronary Aneurysm / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003951:Diagnostic Errors; D004452:Echocardiography; D004830:Epilepsy, Tonic-Clonic / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000209:etiology; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D018836:Inflammation Mediators / Q000097:blood; D008279:Magnetic Resonance Imaging; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000175:diagnosis; D010673:Pheochromocytoma / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D018836:Inflammation Mediators