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[Late recognition of Kawasaki disease--difficulties in diagnosis]

Joanna Kohut1, Ewa Gołba, Grazyna Giec-Fuglewicz

  • 1Z Katedry i Kliniki Kardiologii Dzieciecej.

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|July 4, 2006
PubMed

Insights

A child with Down syndrome developed Kawasaki disease and complete heart block after surgery. Early treatment with immunoglobulins and aspirin is crucial for preventing coronary artery aneurysms.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Genetics

Background:

  • A 4-year-old girl with Down syndrome underwent surgery for common atrioventricular canal and patent ductus arteriosus.
  • A year post-surgery, she developed intermittent complete atrioventricular block, initially deemed non-significant.

Observation:

  • Kawasaki disease was diagnosed based on characteristic symptoms including fever, conjunctivitis, and skin changes.
  • Electrocardiogram (ECG) revealed complete atrioventricular block with significant bradycardia.
  • Echocardiography (ECHO) identified coronary artery aneurysms.

Findings:

  • Standard Kawasaki disease treatment (immunoglobulins, aspirin) was initiated.
  • Orciprenaline was administered for the atrioventricular block.
  • A pacemaker was implanted due to persistent bradycardia.

Implications:

  • Literature review indicates immunoglobulins and aspirin reduce coronary aneurysm risk.
  • Biochemical and physical signs cannot reliably predict aneurysm risk in Kawasaki disease patients.
  • Universal treatment with immunoglobulins is recommended for all affected patients, and a procedural algorithm for coronary aneurysms was presented.

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