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Delayed diagnosis of Kawasaki syndrome and thrombosis of a medium-sized aneurysm of the anterior descending coronary artery: case report and literature review

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Abstract

A 7-year-old child was first admitted for persistent fever of 15-day duration and suspected meningitis. Kawasaki syndrome was lately diagnosed upon the recognition of an extensive diffuse coronary artery damage characterized by medium-sized aneurysms of the epicardial vessels. An eccentric thrombus along the inferior wall of the left anterior descending artery suspected at transthoracic echocardiography was confirmed by coronary computed tomography angiography scan, without significant segmental stenosis. Strict cardiac surveillance and anticoagulant therapy were maintained, and no ischemic complications occurred at a short-term follow-up. This report emphasizes that thrombosis can be observed even in medium-sized aneurysms when the diagnosis of Kawasaki syndrome is delayed.

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Authors and Affiliations

  1. Section of Pediatric Cardiology, Università Cattolica Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy

    Gabriella De Rosa & Angelica Bibiana Delogu

  2. Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Rome, Italy

    Maria Giuseppina Cefalo & Donato Rigante

  3. Department of Bioimaging and Radiological Sciences, Università Cattolica Sacro Cuore, Rome, Italy

    Riccardo Marano

  4. Pediatric Intensive Care Unit, Università Cattolica Sacro Cuore, Rome, Italy

    Marco Piastra

Authors
  1. Gabriella De Rosa
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  2. Maria Giuseppina Cefalo
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  3. Riccardo Marano
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  4. Marco Piastra
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  5. Angelica Bibiana Delogu
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  6. Donato Rigante
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Correspondence to Gabriella De Rosa.

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De Rosa, G., Cefalo, M.G., Marano, R. et al. Delayed diagnosis of Kawasaki syndrome and thrombosis of a medium-sized aneurysm of the anterior descending coronary artery: case report and literature review. Rheumatol Int 32, 809–814 (2012). https://doi.org/10.1007/s00296-011-1814-1

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  • DOI: https://doi.org/10.1007/s00296-011-1814-1

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