川崎病6岁男童三支冠状动脉受累和巨大动脉瘤：病例报告
Triple-vessel coronary involvement and giant aneurysm in a 6-year-old boy with kawasaki disease: a case report.
摘要(中文译文)
川崎病（KD）是一种病因不明的急性全身性血管炎，是儿童获得性心脏病最重要的病因之一。冠状动脉受累是最严重的并发症，可导致动脉瘤形成和血栓形成。然而，三大冠状动脉同时受累并形成巨大动脉瘤较为罕见，通常提示病情严重。本病例报告描述了一名6岁男孩，患有川崎病，尽管接受了标准治疗，仍出现三大冠状动脉的进行性受累。患者在发病第八天接受了静脉注射免疫球蛋白（IVIG）治疗，此后发热消退。然而，随访影像学检查发现左前降支（LAD）巨大动脉瘤，同时左回旋支（LCX）和右冠状动脉（RCA）进行性扩张。在临床病程中，LAD动脉瘤内出现附壁血栓，患者再次入院接受进一步治疗。启动了强化药物治疗，包括糖皮质激素、环孢素、英夫利西单抗、抗凝治疗和抗血小板药物。冠状动脉造影显示LAD部分通畅，远端血流保留；因此，暂缓了外科干预。随访期间，观察到RCA和LCX动脉瘤有所改善，而LAD动脉瘤及相关血栓持续存在。尽管存在这些发现，患者临床状况保持稳定，心功能保留，日常活动正常。本病例报告记录了川崎病中三支冠状动脉受累并伴LAD巨大动脉瘤及血栓形成的罕见情况。本研究强调，尽管存在严重的冠状动脉异常且对标准治疗抵抗，通过药物治疗和密切的长期随访仍可获得良好的临床结局。
Abstract
Kawasaki disease (KD) is an acute systemic vasculitis of unknown origin. It represents one of the most important causes of acquired heart disease in the pediatric population. Coronary artery involvement is the most serious complication and may result in aneurysm formation and thrombosis. However, simultaneous involvement of all three major coronary arteries and giant aneurysm is rare and usually indicates severe disease. This case report describes a 6-year-old boy with KD who developed progressive involvement of all three major coronary arteries despite standard treatment. The patient received intravenous immunoglobulin (IVIG) on the eighth day of illness, after which the fever resolved. However, follow-up imaging revealed a giant aneurysm of the left anterior descending (LAD) artery along with progressive dilation of the left circumflex (LCX) and right coronary arteries (RCA). During the clinical course, mural thrombosis developed within the LAD aneurysm, and the patient was readmitted for further management. Intensive medical therapy was initiated, including corticosteroids, cyclosporine, infliximab, anticoagulation, and antiplatelet agents. Coronary angiography demonstrated partial patency of the LAD with preserved distal run-off; therefore, surgical intervention was deferred. During follow-up, improvement of the aneurysms in the RCA and LCX was observed, whereas the LAD aneurysm and associated thrombosis persisted. Despite these findings, the patient remained clinically stable with preserved cardiac function and normal daily activities. This case report documented a rare occurrence of triple-vessel coronary involvement with a giant LAD aneurysm and thrombosis in KD. This study highlighted that, despite severe coronary abnormalities and resistance to standard treatment, favorable clinical outcomes may still be achieved with medical therapy and close long-term follow-up.
如何引用
AMA
Mohammad-Taghi Majnoon, Mohammad Mehdi Rajabi, Sahar Hemati, Vahid Ziaee, Mohammad Rafati Navaei, Behdad Gharib. Triple-vessel coronary involvement and giant aneurysm in a 6-year-old boy with kawasaki disease: a case report.. BMC cardiovascular disorders. 2026; doi:10.1186/s12872-026-06064-5.
APA
Mohammad-Taghi Majnoon, Mohammad Mehdi Rajabi, Sahar Hemati, Vahid Ziaee, Mohammad Rafati Navaei, Behdad Gharib (2026). Triple-vessel coronary involvement and giant aneurysm in a 6-year-old boy with kawasaki disease: a case report.. BMC cardiovascular disorders. https://doi.org/10.1186/s12872-026-06064-5
GB/T 7714
Mohammad-Taghi Majnoon, Mohammad Mehdi Rajabi, Sahar Hemati, Vahid Ziaee, Mohammad Rafati Navaei, Behdad Gharib. Triple-vessel coronary involvement and giant aneurysm in a 6-year-old boy with kawasaki disease: a case report.[J]. BMC cardiovascular disorders, 2026 doi:10.1186/s12872-026-06064-5.
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