Atypical Kawasaki disease with peripheral gangrene and myocardial infarction: therapeutic implications.

Details

Serval ID
serval:BIB_D221997E75D6
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Atypical Kawasaki disease with peripheral gangrene and myocardial infarction: therapeutic implications.
Journal
European journal of pediatrics
Author(s)
von Planta M., Fasnacht M., Holm C., Fanconi S., Seger R.A.
ISSN
0340-6199
Publication state
Published
Issued date
1995
Peer-reviewed
Oui
Volume
154
Number
10
Pages
830-4
Language
english
Notes
Publication types: Case Reports ; Journal Article - Publication Status: ppublish
Abstract
We describe a 2-month-old girl with atypical Kawasaki disease (KD) complicated by peripheral gangrene and myocardial infarction. Peripheral ischaemia leading to gangrene is a rare but serious complication of KD in infants younger than 7 months of age. Treatment has been targeted at reducing arterial inflammation, arteriospasm and thrombosis. We report the first patient with incomplete KD and peripheral ischaemia in whom therapy with prostaglandin E1 (PGE1) as vasodilating and antithrombotic agent appeared successful, restoring hand and foot perfusion without significant long-term sequelae. However, PGE1 could have supported development of myocardial infarction by shunting blood away from ischaemic areas distal to a giant coronary artery aneurysm with beginning thrombosis. CONCLUSION. Atypical KD with peripheral gangrene appears to react favourably to treatment with PGE1, but needs careful monitoring to detect early signs of cardiac ischaemia.
Keywords
Alprostadil, Coronary Aneurysm, Coronary Circulation, Echocardiography, Electrocardiography, Female, Fibrinolytic Agents, Fingers, Gangrene, Humans, Infant, Ischemia, Mucocutaneous Lymph Node Syndrome, Myocardial Infarction, Toes, Vasodilator Agents
Pubmed
Web of science
Create date
25/01/2008 10:06
Last modification date
20/08/2019 15:52
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