Giant coronary aneurysms in incomplete Kawasaki disease

The association of Kawasaki disease with the formation of aneurysms and coronary stenoses is well established, especially in gammaglobulinnaïve patients. This is the case of a female patient monitored due to patent ductus arteriosus. The control echocardiography performed at the age of 2 years revealed the presence of giant coronary aneurysms in both coronary arteries. The coronary computed tomography angiography (CCTA) and following cardiac catheterization performed confirmed this finding. The patient’s past medical history revealed she had been admitted at the age of 9 months due to fever compatible with pyelonephritis with good response to antibiotic therapy that could have been consistent with incomplete Kawasaki disease due to fever and further desquamation. Antiplatelet and anticoagulant therapies were administered that, to this date, have been maintained indefinitely. When the patient was 6 years old, another echocardiography (figure 1: short axis, Ao, aorta, 1A: right arrow: left coronary aneurysm; left arrow: right coronary aneurysm; arrow 1B: right coronary aneurysm), CCTA (figure 2, right arrows: left coronary aneurysm; left arrows: right coronary aneurysm), and cardiac catheterization were performed that revealed the presence of 2 17 mm x 8.8 mm and 7.3 mm × 5.3 mm calcified aneurysms in the right coronary artery (figure 3A,B..