Successful intravenous streptokinase treatment of a child with Kawasaki disease complicated by acute myocardial infarction

Liang, Chi-Di; Huang, Song‐Chei; Su, Wen‐Jen; Chen, Hui‐Yung; Lee, Chiang‐Hsuan

doi:10.1002/ccd.1810350213

Cited by 11 publications

(3 citation statements)

References 12 publications

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“…One case reported successful use of 3500 U/kg over 30 minutes, followed by a 24-hour infusion at 1000 U/kg/h [20].…”

Section: Streptokinasementioning

confidence: 99%

“…Both intravenous and intracoronary regimens of streptokinase [20], urokinase [21], and tissue plasminogen activator [22,23] have been reported, but no clear evidence exists regarding the superiority of intravenous versus intracoronary administration, or whether one agent is superior to the other. The majority of authors support a trial of intracoronary thrombolysis in patients who present with coronary thrombosis with or without ischemia.…”

Section: Recommendations For Long-term Follow-upmentioning

confidence: 99%

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Kawasaki disease: Current therapeutic perspectives

Michelfelder

Shim

2002

Curr Treat Options Cardio Med

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Kawasaki disease is an acute systemic vasculitis of unknown etiology that has become the most common form of acquired heart disease in young children in developing countries. The most serious threat from Kawasaki disease is the development of coronary vasculitis, with subsequent development of aneurysms, thrombosis, and coronary compromise. Standard treatment during the acute phase of Kawasaki disease now consists of intravenous gamma globulin, 2 g/kg, given as a single dose, and high-dose aspirin therapy, 80 to 100 mg/kg daily. When instituted within 10 days of the onset of illness, this approach has reduced the incidence of coronary artery abnormalities from 20% to 25% to approximately 5% at 6 to 8 weeks after initiation of treatment. Despite these therapeutic successes, the optimal management of certain patient groups with Kawasaki disease remains unclear or controversial. This includes patients with persistent or recrudescent fever and inflammation despite prompt initiation of standard therapy, and patients developing coronary arterial aneurysms. For patients with persistent or recrudescent fever, there are increasing reports suggesting that corticosteroid therapy, in addition to retreatment with intravenous gamma globulin, may be useful. Newer antiplatelet agents are being introduced that may improve outcome in children who develop acute coronary artery lesions. Long-term therapy of patients with coronary artery aneurysms typically consists of long-term aspirin therapy; the use of additional antiplatelet agents and anticoagulants is often used in clinical practice, but not universally accepted.

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“…One case reported successful use of 3500 U/kg over 30 minutes, followed by a 24-hour infusion at 1000 U/kg/h [20].…”

Section: Streptokinasementioning

confidence: 99%

Section: Recommendations For Long-term Follow-upmentioning

confidence: 99%

Kawasaki disease: Current therapeutic perspectives

Michelfelder

Shim

2002

Curr Treat Options Cardio Med

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“…Experience related to the efficacy of streptokinase in PMI has been acquired from Kawasaki patients in particular. Studies have shown that in Kawasaki patients with MI, the use of intravenous or intra-coronary streptokinase followed by heparinisation and warfarin or dipyridamol in maintenance, is effective [87,88]. If Percutaneous Coronary Intervention (PCI) is not applied within the first 2 hours after diagnosis in cases with MI, immediate thrombolytic treatment should be applied with a half-hour infusion.…”

Section: Streptokinasementioning

confidence: 99%

Myocardial Infarction in Children

Bilici¹,

Türe²,

Balık³

2019

Myocardial Infarction

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Myocardial infarction (MI) is a clinical condition that develops associated with a sudden reduction or interruption of the blood flow of the vessels supplying the heart for various reasons. The electrocardiographic, echocardiographic and enzymatic diagnostic criteria of MI have been well defined in adults, in children there are some difficulties. Although seen more often in the presence of congenital heart disease (CHD), MI may also be seen in patients without CHD. Unlike atherosclerotic coronary artery disease in adult patients, ischaemia and infarct in children are often associated with coronary artery anomalies and CHD. In addition, congenital prothrombotic diseases, vasculitis, surgical or interventional procedures may also cause ischaemia and infarct. Subendocardial ischaemia, especially aortic stenosis characterised by hypertrophy in the left ventricle is often seen in hypertrophic cardiomyopathy or hypertensive patients. The most important risk factors in neonates and infants are the presence of CHD, coronary artery anomalies and perinatal asfixia. The most frequently seen causes of pediatric myocardial infarction (PMI) are abnormal left coronary artery originating from the pulmonary artery (ALCAPA) and Kawasaki disease. Another often seen cause of PMI is patients who underwent arterial switch operations.

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Anatomie und Pathologie der Koronararterien

Hort¹,

Schwartzkopff²

2000

Pathologie Des Endokard, Der Kranzarterien Und Des Myokard

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Successful intravenous streptokinase treatment of a child with Kawasaki disease complicated by acute myocardial infarction

Cited by 11 publications

References 12 publications

Kawasaki disease: Current therapeutic perspectives

Kawasaki disease: Current therapeutic perspectives

Myocardial Infarction in Children

Anatomie und Pathologie der Koronararterien

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