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Unresponsive and late intravenous immunoglobulin of giant aneuryms after kawasaki disease



Abstract

Giant aneurysm is rare complication of Kawasaki disease (KD) and has highest risk for arterial occlusion. We report an 8.5 years old boy who was diagnosed with giant aneurysm, after diagnosed  with KD. Echocardiography during acute phase was found lesions at left main ostium coronary artery (LMCA), left anterior descending artery (LAD), and right coronary artery (RCA). Patient was treated with single dose intravenous immuno globulin (IVIG) at 14th of illness. Recurrent fever, hypoalbuminemia, rising c-reactive protein (CRP), and thrombocytosis occurred after IVIG administration, patient then given methylprednisolone pulse dose. Coronary angiography showed giant aneurysm LMCA, proximal left circumflex artery (LCx), proximal RCA, proximal LAD and total occlusion proximal RCA but no ischemia found through electrocardiogram tests. The patient control regularly with aspirin, warfarin, and bisoprolol therapy. The patient does not have any complain. Unresponsive and late intravenous immunoglobulin therapy in KD are significant risk factors for coronary artery lesions.

 

 

Keywords: giant aneurysm Kawasaki disease coronary artery aneurysm unresponsive to immunoglobulin therapy coronary artery occlusion

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How to Cite

Wardani, T., & Gunawijaya, E. (2018). Unresponsive and late intravenous immunoglobulin of giant aneuryms after kawasaki disease. Medicina, 49(2). https://doi.org/10.15562/medicina.v49i2.62
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Tristina Wardani
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Medicina Journal

Eka Gunawijaya
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Medicina Journal