Multiresistant Kawasaki Disease Complicated With Facial Nerve Palsy, Bilateral Giant Coronary Artery Aneurysms, and Stenosis of the Right Coronary Artery in an Infant

Peña-Juárez, Alejandra; Medina-Andrade, Miguel A.; Olivares, Itzel Estefani Rios; Colín-Ortíz, José Luis; Yamazaki‐Nakashimada, Marco Antonio; Garrido-Garcı́a, Luis Martı́n

doi:10.1097/rhu.0000000000001586

Cited by 5 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although multiresistant KD patients are rare, these cases present a medical dilemma, and different combinations of medications have been used. [7] Probably due to the lack of response to multiple treatments, our patient developed a giant left anterior descending CAA according to. the 2017 criteria of American Heart Association guidelines.…”

Section: Discussionmentioning

confidence: 96%

Giant coronary aneurysm in a 6‐week‐old infant, an unusual finding?

et al. 2022

View full text Add to dashboard Cite

Kawasaki disease (KD) is a self-limited vasculitis with significant morbidity and even mortality if not treated early. The diagnosis and timely treatment in children younger than 3 months is challenging as most of them have an incomplete or atypical presentation. Coronary artery abnormalities are frequent in this type of patients. We present a 6-week-old female infant with KD who developed a giant coronary aneurysm. An early diagnosis and promptly treatment, as well as the echocardiographic and multimodality follow-up allowed us to improve our clinical approach and management.

show abstract

Section: Discussionmentioning

confidence: 96%

Giant coronary aneurysm in a 6‐week‐old infant, an unusual finding?

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Multiresistant KD is defined as the need for three or more drugs beyond IVIg to control acute inflammation [18]. The rate of resistance to a first dose of IVIg has increased over the years [18], and it is related to CAAs development [13].…”

Section: Discussionmentioning

confidence: 99%

Multiresistant Kawasaki Disease in a Young Infant with Giant Aneurysms Growing Fast

Amorim-Figueiredo,

Pereira Lemos,

Rito

et al. 2024

JCDD

View full text Add to dashboard Cite

Background: Kawasaki disease (KD) is a type of vasculitis in which giant coronary artery aneurysms (CAAs) can occur. There are no specific guidelines for managing giant CAAs that develop quickly and are at risk of rupture. Regarding cardiovascular drugs, only beta-blockers are formally recommended in the acute phase of KD. Case presentation: A 6-month-old male patient with multiresistant Kawasaki disease and giant CAAs that continued to enlarge after controlling systemic inflammation was examined. The patient required three doses of intravenous immunoglobulin, methylprednisolone pulses, and anakinra and infliximab to normalize systemic inflammation. Due to the rapid increment of aneurysms’ dimensions and the risk of rupture, we introduced anticoagulant therapy and propranolol plus captopril, and titration doses were introduced according to a tolerated decrease in heart rate and arterial pressure. CAAs increment stabilized and slowly reduced their dimensions. Conclusions: The authors describe an atypical case of multiresistant KD with giant rapidly increasing CAAs even after controlling systemic inflammation. The introduction of a beta-blocker and an angiotensin-converting enzyme (ACE) inhibitor was demonstrated to be useful for stabilizing giant CAAs growth and reducing the potential risk of rupture.

show abstract

“…To date, about 50 cases of infants with KD-associated FNP have been described. Table 3 summarizes the clinical features, treatment, and prognosis of 35 patients with KD and FNP [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Incomplete Kawasaki Disease with Peripheral Facial Nerve Palsy and Lung Nodules: A Case Report and Literature Review

et al. 2023

View full text Add to dashboard Cite

The diagnosis of Kawasaki disease (KD) is challenging and often delayed mainly in case of young infants and in presence of an incomplete disease and atypical features. Facial nerve palsy is one of the rare neurologic symptoms of KD, associated with a higher incidence of coronary arteries lesions and may be an indicator of a more severe disease. Here, we describe a case of lower motor neuron facial nerve palsy complicating KD and perform an extensive literature review to better characterize clinical features and treatment of patients with KD-associated facial nerve palsy. The patient was diagnosed at the sixth day of disease and presented extensive coronary artery lesions. A prompt treatment with intravenous immunoglobulins, aspirin and steroids obtained a good clinical and laboratory response, with resolution of facial nerve palsy and improvement of coronary lesions. The incidence of facial nerve palsy is 0.9–1.3%; it is often unilateral, transient, more frequent on the left and seemingly associated with coronary impairment. Our literature review showed coronary artery involvement in the majority of reported cases (27/35, 77%) of KD with facial nerve palsy. Unexplained facial nerve palsy in young children with a prolonged febrile illness should prompt consideration of echocardiography to exclude KD and start the appropriate treatment.

show abstract

Multiresistant Kawasaki Disease Complicated With Facial Nerve Palsy, Bilateral Giant Coronary Artery Aneurysms, and Stenosis of the Right Coronary Artery in an Infant

Cited by 5 publications

References 16 publications

Giant coronary aneurysm in a 6‐week‐old infant, an unusual finding?

Giant coronary aneurysm in a 6‐week‐old infant, an unusual finding?

Multiresistant Kawasaki Disease in a Young Infant with Giant Aneurysms Growing Fast

Incomplete Kawasaki Disease with Peripheral Facial Nerve Palsy and Lung Nodules: A Case Report and Literature Review

Contact Info

Product

Resources

About