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Coronary aneurysms in a child: an unusual presentation of pseudovasculitis

Luciana P C Seguro1, Jozelio Freire de Carvalho, Alessandro C Lianza

  • 1Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. lucianapc@gmail.com

Clinical and Experimental Rheumatology
|November 10, 2012
PubMed

Insights

Kawasaki disease can cause coronary artery aneurysms in children. A rare case highlights pheochromocytoma as a cause of these aneurysms, mimicking vasculitis and resolving after tumor removal.

Area of Science:

  • Pediatric Cardiology
  • Pediatric Endocrinology
  • Pediatric Oncology

Background:

  • Kawasaki disease is the leading cause of acquired pediatric coronary artery disease.
  • Coronary artery abnormalities are uncommon in children.
  • Pheochromocytoma is a rare tumor causing hypertension.

Observation:

  • A female child presented with coronary artery aneurysms and convulsions, initially diagnosed with Kawasaki disease.
  • Despite treatment for Kawasaki disease, hypertension and inflammation persisted.
  • Further investigation revealed a pheochromocytoma.

Findings:

  • Surgical removal of the pheochromocytoma normalized blood pressure and inflammatory markers.
  • Coronary aneurysms progressively reduced, normalizing within 8 months.
  • This case represents the first description of pheochromocytoma-associated coronary aneurysms presenting as pseudovasculitis.

Implications:

  • Pheochromocytoma should be considered in pediatric cases of coronary aneurysms with persistent hypertension and inflammation.
  • Early diagnosis and surgical management of pheochromocytoma can lead to resolution of coronary aneurysms.
  • This finding expands the differential diagnosis for pediatric vasculitis syndromes.

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