Summary
Kawasaki disease primarily affects children below 5 years of age, and fatal coronary complications usually occur within 6–12 months following the acute illness. We report 2unusual fatal cases of thrombosed coronary artery aneurysms. The first case was an 11-year-old boy, who died suddenly 2 months after the acute illness. He had a classical clinical picture, but was misdiagnosed. The second case was a 29-year-old man without history of recent febrile episodes or cardiac symptoms. Bothsubjects fulfilled the stage 4 criteria of Kawasaki disease (healing stage) with extensive old myocardial damage. The cases illustrate the great variation in the clinical picture of Kawasaki disease. Teenagers can also be affected, and extensive myocardial damage may be asymptomatic formany years.
Zusammenfassung
Die Kawasaki-Krankheit betrifft primär Kinder im Lebensalter unter 5 Jahren, und akute koronare Komplikationen entstehen normalerweise innerhalb von 6–12 Monaten nach der akuten Erkrankung. Wir berichten über 2 ungewöhnliche Fälle von thrombosierten Koronar-Aneurysmen. Im ersten Fall handelte es sich um einen 11jährigen Jungen, welcher plötzlich 2 Monate nach der akuten Erkrankung verstarb. Er hatte ein klassisches klinisches Bild, aber dieses wurde fehldiagnostiziert. Der zweite Fall war ein 29 Jahre alter Mann ohne Anamnese, mit rezenten fieberhaften Episoden oder kardialen Symptomen. Beide Personen erfüllten die Kriterien des Stadiums 4 der Kawasaki-Krankheit (Heilungsstadium) mit ausgeprägten alten myokardialen Schäden. Die Fälle zeigen, daß eine große Variation im klinischen Bild der Kawasaki-Krankheit existiert. Auch Teenager können betroffen sein, und ausgeprägte myokardiale Schäden können für viele Jahre asymptomatisch sein.
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Kristensen, I.B., Kristensen, B.Ø. Sudden death caused by thrombosed coronary artery aneurysm. Int J Leg Med 106, 277–280 (1994). https://doi.org/10.1007/BF01225421
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DOI: https://doi.org/10.1007/BF01225421