Incomplete form of kawasaki disease with coronary and peripheral artery aneurysms and immunoglobulin-resistant course

Mucocutaneous lymphonodular syndrome (Kawasaki disease-KD) is a systemic vasculitis of middle and small arteries, clinically manifested by fever, changes in the mucous membranes, skin, lymphadenopathy. Lesion of cardiovascular system occurs in approximately 50% of patients; in 25-40% without treatment, artery aneurysms are formed. The incidence of peripheral arteries lesion is 2%. The main method of treatment is intravenous immunoglobulin (IVIG) at a dose of 2 g/kg and acetylsalicylic acid. However, 10-30% of patients can have resistance to standard therapy. In this case, the use of inhibitors of tumor necrosis factor alpha is recommended. The article presents clinical observation of a child with an incomplete form of KD, giant coronary and peripheral artery aneurysms, resistance to IVIG therapy and a complication in the form of a thrombus in the left coronary artery. © 2018, Pediatria Ltd. All rights reserved.