1/26. ticlopidine plus aspirin for coronary thrombosis in Kawasaki disease.Selective inhibitors of the adenosine 5'-diphosphate pathway of platelet activation have been used rarely in children in the united states. We report the successful use of ticlopidine, together with aspirin, in a 7-month-old infant with Kawasaki disease complicated by a thrombus in a giant coronary aneurysm that failed to resolve with thrombolytic therapy. Kawasaki disease, coronary aneurysms, antithrombotic therapy, ticlopidine, children.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/26. coronary artery bypass grafting in adult coronary artery disease due to suspected Kawasaki disease in childhood.Development of coronary artery aneurysms is one typical complication of Kawasaki disease and can cause coronary artery disease even in early childhood. Information about course and outcome in adults is rare. Here, we present a 49-year-old man with serious three-vessel coronary artery disease and giant coronary artery aneurysms following suspected Kawasaki disease.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/26. Acute myocardial infarction due to a regressed giant coronary aneurysm as possible sequela of Kawasaki disease.We report on a young patient admitted with an acute myocardial infarction due to a regressed coronary aneurysm who was treated with balloon angioplasty. The wall morphology of the coronary aneurysm using intravascular ultrasound imaging closely resembled that occurring after Kawasaki disease (KD), although our patient had no obvious past history of KD, suggesting so-called atypical KD.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
4/26. Rotational ablation and stent placement for severe calcific coronary artery stenosis after Kawasaki disease.We report on a 5-year-old child who had an episode of Kawasaki disease with giant coronary artery aneurysms at the age of 4 months. Surveillance coronary angiography showed severe calcific stenosis in the proximal left anterior descending artery. Balloon angioplasty failed to resolve the obstruction. Rotational ablation was therefore performed. Surveillance angiogram performed 6 months after rotational ablation showed critical restenosis. Rotational ablation was therefore repeated, followed by stent placement. To the best of our knowledge, this is the youngest child who has undergone coronary stenting after Kawasaki disease.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/26. "Unresolving pneumonia" as the main manifestation of atypical Kawasaki disease.Two cases of atypical Kawasaki disease (KD) manifested as persistent lobar lung consolidation, prolonged fever, and active inflammatory laboratory markers unresponsive to antibiotic treatment are reported. One of the children developed a giant coronary aneurysm. Atypical KD should be considered in the differential diagnosis of young children with prolonged fever and lobar consolidation unresponsive to antibiotics.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/26. pulse methylprednisolone therapy in the treatment of immune globulin-resistant Kawasaki disease: case report and review of the literature.A subgroup of patients with Kawasaki disease (KD) did not respond to intravenous immune globulin (IVIG) therapy. Corticosteroid therapy remains a controversial alternative in such cases. We report two young children with KD who failed to respond to three courses of IVIG therapy and subsequently received pulse methylprednisolone as an alternative. One had a satisfactory outcome but the other developed giant coronary aneurysms and had a myocardial infarction 2 months after onset of the illness. A review of relevant literature showed that the timing of initiation of pulse methylprednisolone therapy is important. It is suggested that pulse methylprednisolone therapy should be considered if there is no response to two standard doses of IVIG treatment.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/26. Infliximab as a novel therapy for refractory Kawasaki disease.Kawasaki disease (KD) is a multisystem vasculitis of unknown etiology, with coronary artery aneurysms occurring in 25% of untreated cases. With conventional treatment of intravenous immunoglobulin (i.v.IG) and high dose aspirin (ASA) only 4% of patients develop coronary artery aneurysms. Children who are unresponsive present a challenge. tumor necrosis factor-alpha levels peak during the acute and subacute phase of KD, especially in children who develop coronary artery aneurysms. We describe a 3-year-old male with KD and giant coronary artery aneurysms, unresponsive to multiple doses of i.v.IG and methylprednisolone, who was treated with infliximab. After the first dose he defervesced and his laboratory measures improved.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/26. rupture of a giant coronary artery aneurysm due to Kawasaki disease.Coronary artery aneurysm requiring surgery is rare. We report a case of a ruptured giant coronary artery aneurysm due to Kawasaki vasculitis which presented with cardiac arrest and was successfully treated by emergency coronary artery bypass grafting. The controversies surrounding the management of this disease are also discussed.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
9/26. Peripheral gangrene associated with Kawasaki disease.Three American infants with Kawasaki disease (KD) complicated by peripheral extremity gangrene are reported. Eight such patients (only 1 from japan) have been reported previously. These 11 patients, infants less than 7 months old at onset of KD, are predominantly non-Asian. At least nine had associated giant coronary aneurysms, and eight had associated peripheral arterial aneurysms. In eight infants the diagnosis of KD was not established and therapy was not instituted until greater than or equal to 14 days after onset. Peripheral ischemia initially was noted 15-31 days after onset. Although the pathogenesis of this complication is not well understood, it likely includes some combination of local peripheral arteritis, arteriospasm, thrombosis peripherally and/or more proximally (e.g., in an axillary artery aneurysm), and cardiogenic shock. Treatment may include use of antiinflammatory agents such as salicylates and intravenous gamma globulin, vasodilative agents and/or methods, and thrombolytic and/or anticoagulant agents in an attempt to prevent the potentially devastating consequences of progressive gangrene.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/26. Assessment of coronary artery abnormalities in a patient with Kawasaki disease by multislice computed tomography.The high spatial resolution of multislice computed tomography (MSCT) permits direct visualization of the coronary artery system. In this report, we describe coronary artery abnormalities in a young adult with Kawasaki disease. MSCT detected a giant coronary artery aneurysm, coronary artery stenosis in the first diagonal artery, and a multi-layered structure in the right coronary artery and the left circumflex artery. These findings corresponded well to those obtained by coronary angiography. MSCT has the potential to be the standard diagnostic tool for the follow-up evaluation of coronary artery disease in adolescents and young adults with Kawasaki disease.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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