Peripheral arterial aneurysms in a toddler

Arunakumar, Priyadarshini; Ayyappan, Anoop; Sivasubramonian, Sivasankaran; Valaparambil, Ajitkumar

doi:10.1093/ehjci/jex249

Cited by 6 publications

(3 citation statements)

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“…However, many case reports in the current era have also revealed that SAAs are almost always associated with giant CAAs. [5][6][7]11,14,16,22,23 With these data, it is reasonable to assume that even screening patients with giant CAAs may in part reflect the incidence of SAAs in all patients with KD.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] Since the advent of intravenous immunoglobulin (IVIg) therapy, almost all English-language literature on KD-related SAAs consist of case reports revealing that axillary, subclavian, brachial, iliac, and femoral arteries are common sites of involvement. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] To date, there are only 2 reports from the same Japanese medical center in which authors reported the incidence of SAAs in patients with KD, but, in fact, less than half of their patients with KD were screened for SAAs; it was during their study that they found that only patients with giant CAAs developed SAAs. 3,4 Although it is a reasonable assumption that there is a concomitant decrease in SAA formation with early IVIg therapy, as well as a decrease in CAAs, there are no published data to support this.…”

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confidence: 99%

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Systemic Artery Aneurysms and Kawasaki Disease

Zhao

Chu

et al. 2019

Pediatrics

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BACKGROUND: Coronary artery aneurysms (CAAs) are a well-known complication of Kawasaki disease (KD), but there are no data on incidence or outcomes of systemic artery aneurysms (SAAs) in the current era. METHODS: From April 1, 2016, to March 31, 2019, we screened for SAAs in 162 patients with KD at risk for SAAs with magnetic resonance angiography or peripheral angiography and analyzed incidence and early outcomes of SAAs. RESULTS: Twenty-three patients had SAAs, demonstrating an incidence of 14.2% (23 of 162) in patients who were screened at 1 month after onset. The proportion of patients with SAAs was estimated to be 2% (23 of 1148) of all patients with KD. The median age at onset of KD with SAAs was 5 months. All patients with SAAs had CAAs, with z scores .8. Of patients with giant CAAs, 38.6% (17 of 44) had SAAs. A total of 129 SAAs occurred in 17 different named arteries. The most common sites for SAAs were the axillary (18.6%), common iliac (12.4%), and brachial (11.6%) arteries. During a median follow-up time of 6 months, 92.9% (79 of 85) of SAAs had some degree of regression, with 80% (68 of 85) of SAAs returning to normal. The overall regression rate was higher for medium to large SAAs than for medium to giant CAAs. CONCLUSIONS: Although the incidence of SAAs may not be as dramatically reduced as we expected compared with previous data, SAAs have a high regression rate during short-term follow-up. WHAT'S KNOWN ON THIS SUBJECT: Studies from the 1980s revealed that systemic artery aneurysms (SAAs) may occur in 0.8% to 2% of patients with Kawasaki disease at 3 months after onset. It is speculated that SAAs are now much less common than before. WHAT THIS STUDY ADDS: SAAs occur in 14.2% of patients at risk for SAAs at 1 month after onset, giving an estimated proportion of patients with SAAs as 2% of all patients with Kawasaki disease. SAAs have a high regression rate during short-term follow-up.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Systemic Artery Aneurysms and Kawasaki Disease

Zhao

Chu

et al. 2019

Pediatrics

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“…There are no diagnostic tests available to confirm the disease. Therefore, its diagnosis is based on clinical criteria, namely, fever lasting for five days or more together with at least four of its five principal clinical features [ 4 ]. These include cervical lymphadenopathy (usually unilateral), bilateral non-exudative conjunctivitis, oral mucous membrane changes such as erythema/cracking of lips, strawberry tongue, and/or erythema of oral and pharyngeal mucosa, changes in the extremities, including erythema and edema of the hands and feet, and skin polymorphous rash [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Unusual Manifestations of Kawasaki Disease in the COVID Era: A Case Series and Review of the Literature

Kostara,

Serbis,

Pavlou

et al. 2023

Cureus

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Kawasaki disease (KD) is an acute medium-vessel vasculitis, mainly affecting infants older than six months and children under five years. It predisposes to the development of coronary artery aneurysms and constitutes the leading cause of acquired heart disease in children. Its diagnosis is based on clinical criteria, namely, fever lasting for ≥ five days together with at least four of the five principal clinical features of the disease. Occasionally, children with KD present with fever, but they fulfill only some of the five principal criteria, and this is described as incomplete KD. Furthermore, "atypical" KD is a term that is usually used for cases that appear with rather unusual clinical manifestations, which complicate clinical judgment and may delay diagnosis and treatment. In this case series, we present four cases of KD with rather unusual clinical features: a five-year-old boy with lobar pneumonia, a six-year-old girl with orange-brown chromonychia appearing on the 10 th day of the disease, a 2.5-month-old infant with prolonged fever and urinary tract infection, and an 18-month-old infant with refractory KD and high suspicion of multisystem inflammatory syndrome in children (MIS-C). A literature review on the unusual manifestations of atypical KD was performed to identify clinical findings that must alert the clinician to consider this clinical entity.

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