Asymmetric perfusion-related complications in Kawasaki disease: a 13-year longitudinal case report

Area of Science:

• Pediatric Cardiology
• Vascular Biology
• Rheumatology

Background:

• Kawasaki disease is a leading cause of acquired pediatric heart disease.
• Aneurysms, particularly in the axillary arteries, are a known complication of severe Kawasaki disease.
• Long-term sequelae of these aneurysms are not well-documented.

Purpose of the Study:

• To report the 13-year clinical course and vascular outcomes in a patient with severe Kawasaki disease and bilateral axillary artery aneurysms.
• To illustrate the potential for asymmetric peripheral complications arising from long-term arterial flow disturbances.
• To emphasize the importance of extended vascular surveillance in affected children.

Main Methods:

• Serial imaging (ultrasound, angiography) over 13 years.
• Morphometric measurements of affected limbs.
• Microvascular assessment of peripheral circulation.

Main Results:

• Right axillary artery occlusion resulted in progressive upper limb hypoplasia.
• Contralateral axillary artery aneurysm changes led to unilateral digital clubbing.
• Documented asymmetric peripheral outcomes due to chronic arterial flow disturbances.

Conclusions:

• Severe Kawasaki disease with axillary artery aneurysms can lead to unique, asymmetric long-term peripheral complications.
• Extended vascular screening is crucial for managing patients with Kawasaki disease-associated aneurysms.
• This case highlights the dynamic nature of arterial aneurysms and their impact on limb development and vascular health.