Document Detail


Atypical Kawasaki disease with peripheral gangrene and myocardial infarction: therapeutic implications.
MedLine Citation:
PMID:  8529683     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M von Planta; M Fasnacht; C Holm; S Fanconi; R A Seger
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  European journal of pediatrics     Volume:  154     ISSN:  0340-6199     ISO Abbreviation:  Eur. J. Pediatr.     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1996-01-29     Completed Date:  1996-01-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7603873     Medline TA:  Eur J Pediatr     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  830-4     Citation Subset:  IM    
Affiliation:
Division of Immunology/Haematology, University Children's Hospital Zürich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Alprostadil / administration & dosage*,  adverse effects
Coronary Aneurysm / diagnosis,  drug therapy
Coronary Circulation / drug effects
Echocardiography / drug effects
Electrocardiography / drug effects
Female
Fibrinolytic Agents / administration & dosage*,  adverse effects
Fingers / blood supply*
Gangrene
Humans
Infant
Ischemia / diagnosis,  drug therapy*
Mucocutaneous Lymph Node Syndrome / diagnosis,  drug therapy*
Myocardial Infarction / chemically induced,  diagnosis,  drug therapy*
Toes / blood supply*
Vasodilator Agents / administration & dosage*,  adverse effects
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Vasodilator Agents; 745-65-3/Alprostadil

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