Abstract
Case Report: A 2-year-old female was referred to our hospital because of fever, skin rash, conjuncvital injection, strawberry tongue and erythema and edema of the hands and feet. Under the diagnosis of Kawasaki disease, intravenous γ-globrin (400mg/kg/day, for 5 days) and high-dose of aspirin (50mg/kg/day, orally) were started. However, the disease was refractory, so additional intravenous γ-globrin had to be done two times. The febrile duration was 18 days. Chest x-ray on 27th day after the onset revealed a partial projection of the descending aorta, which was not detected on chest x-ray on admission. However, the projection of the descending aorta was not detectable using ultrasonography. Echocardiography performed 22 days after the onset showed mild dilatations in right and left coronary arteries. Although normal coronary arteries were seen on selective coronary angiogram, the thoracic aortic aneurysm which was 19mm in diameter was disclosed on aortogram. Therefore, the abnormal projection of descending aorta on chest x-ray indicated the aortic aneurysm. The size of the aneurysm on chest x-ray has not changed for 2 years. In Kawasaki disease, there are a few case reports on abdominal aortic aneurysm, but thoracic aortic aneurysm has not been described yet. It is difficult to detect thoracic aortic aneurysm using ultrasonography, although the abdominal aortic aneurysm is detectable. Conclusion: In patients with refractory Kawasaki disease, we should consider the complication of thoracic aortic aneurysm in addition to abdominal aortic aneurysm, and careful observations of the changes in the shape of the thoracic descending aorta on chest x-ray are important.
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Ito, T. Thoracic Aortic Aneurysm Associated with Kawasaki Disease. Pediatr Res 53, 178 (2003). https://doi.org/10.1203/00006450-200301000-00147
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DOI: https://doi.org/10.1203/00006450-200301000-00147