一名川崎病儿童患者的广泛冠状动脉血栓形成:病例报告

Tilbe Kasap, Inga Voges, K. Rinne, P. Langguth
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引用次数: 0

摘要

川崎病(KD)是一种小儿多系统血管炎。急性炎症主要影响冠状动脉,并可能形成冠状动脉瘤(CAA)。随着 CAA 的增大,出现临床并发症和严重心脏后果的风险也会增加。如果不及时启动抗血小板和抗凝治疗,这些患者可能会出现危及生命的血栓性冠状动脉闭塞和心肌缺血。[1]本病例报告了一名 12 岁的川崎病患者,尽管在确诊 CAA 后就开始了抗血栓治疗,但患者最初静脉注射了免疫球蛋白和乙酰水杨酸(ASA),随后两支冠状动脉都出现了广泛的血栓形成。 我们的病例之所以值得注意,是因为尽管使用了抗血小板药物和抗凝剂,但临床表现仍然很严重。可以推测,该病例冠状动脉血栓的形成可能与口服抗凝药物的晚期使用密切相关。对如此年轻的患者来说,受影响冠状动脉的高质量图像可能具有教育价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Extensive coronary artery thrombosis in a pediatric patient with Kawasaki disease: A Case Report
Kawasaki disease (KD) is a pediatric multi-system vasculitis. Mainly the coronary arteries become affected due to acute inflammation and formation of coronary artery aneurysms (CAAs) may occur. As the size of the CAA increases, so does the risk of clinical complications and serious cardiac outcomes. These patients may experience life threatening thrombotic coronary artery occlusion and myocardial ischemia unless anti-platelet and anti-coagulation therapy is not initiated in a timely manner. [1] This case report presents a 12-year-old patient with Kawasaki disease who developed CAAs in two coronary arteries despite initial administration of intrave-nous immunoglobulins and acetylsalicylic acid (ASA), followed by extensive thrombosis of both coronary arteries, although antithrombotic therapy was started after the diagnosis of CAAs. Our case is notable because of the severity of the clinical manifestation de-spite the administration of antiplatelet agents and anticoagulants. It could be speculated that the development of coronary thrombosis in this case might be strongly correlated with the late initiation of oral anticoagulation. The high-quality images of the affected coronary arteries in such a young patient could be of educational value.
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