Multiple Giant Aneurysms at Both the Right and Left Coronary Arteries in Incomplete Kawasaki Disease

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  • Yoshimura Satoshi
    Department of Postgraduate Education and Training, National Center for Child Health and Development
  • Ono Hiroshi
    Division of Cardiology, National Center for Child Health and Development
  • Masuda Hiroshi
    Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development
  • Kobayashi Tohru
    Department of Management and Strategy, Clinical Research Center, National Center for Child Health and Development
  • Fukuda Sayaka
    Department of Pediatrics, Saiseikai Yokohamashi Tobu Hospital
  • Katsumori Hiroshi
    Department of Pediatrics, Kawakita General Hospital
  • Kato Hitoshi
    Division of Cardiology, National Center for Child Health and Development
  • Abe Jun
    Noma Pediatric Clinic
  • Ishiguro Akira
    Department of Postgraduate Education and Training, National Center for Child Health and Development

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<p>Incomplete Kawasaki disease (iKD) is widely accepted as a risk factor for developing coronary artery lesions, partly because of a delay in treatment initiation. However, its association with giant aneurysm (GA) formation has rarely been reported. Here we report a 3-year-old boy with iKD who developed multiple GAs at both the right and left coronary arteries. The boy was admitted to a previous hospital for fever lasting for seven days and conjunctival injection. First, he was treated with antibiotics, but his fever did not resolve. Echocardiography revealed remarkable dilatation of the bilateral coronary arteries. He was transferred to our hospital under the diagnosis of iKD on day 11 of illness. His symptoms improved immediately after the administration of intravenous immunoglobulin, but the diameter of his coronary aneurysms increased. Coronary angiography performed three months after onset revealed multiple GAs at both coronary arteries. An aneurysm at the right coronary artery occluded two years from onset. In case of prolonged fever of unknown origin, it is important to consider incomplete KD and carefully examine echocardiograms, even when there are few major KD symptoms present.</p>

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