Kawasaki disease (KD) is an acute febrile, systemic vasculitic syndrome of unknown etiology, occurring
primarily in children younger than 5 years of age. Administration of IVIG within the first 10 days after onset
of fever in combination with high dose aspirin reduces the risk of coronary artery damage in KD. Though
rare, giant aneurysms of the coronary arteries may develop in untreated cases and prove extremely
challenging to manage.
A 9-month-old Caucasian boy presented to our paediatric emergency department with a 4-week history of
intermittent pyrexia and irritability. Typical mucocutaneous signs of Kawasaki Disease were absent upon
presentation. A trans-thoracic echocardiogram identified a giant aneurysm of the left anterior descending
artery with thrombus formation in-situ and the child was managed with intravenous immunoglobulin,
steroids, high dose aspirin therapy and later warfarinisation.
Cardiovascular sequelae of Kawasaki disease include giant coronary artery aneurysms with thrombosis.
Enlargement of a coronary aneurysm after the acute phase of Kawasaki disease is uncommon and the
outcome of interventional approaches poorly studied.peer-reviewe