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Giant coronary artery aneurysms complicating Kawasaki disease in Mexican children

  • Luis M. Garrido-García (a1), Edna Morán-Villaseñor (a2), Marco A. Yamazaki-Nakashimada (a3), Patricia Cravioto (a4) and Fernando Galván (a4)...



One of the most important complications of Kawasaki disease is the development of giant coronary aneurysms. Risk factors for their development are still not clear.


A retrospective analysis was conducted at the National Institute of Paediatrics in Mexico City, Mexico. It included all patients with a diagnosis of acute Kawasaki disease between August, 1995 and August, 2015. Clinical and laboratory findings, as well as echocardiographic measurements, were recorded. Patients with giant coronary aneurysms (z-score⩾10) were compared with the rest of the patients. A value of p<0.05 was considered statistically significant. Odds ratios and their 95% confidence intervals were calculated to define risk factors.


During the study period, 416 patients were diagnosed with Kawasaki disease. Of them, 34 developed giant coronary aneurysms during the acute stage of the disease. In the multivariate analysis, patients younger than 1 year, those with a higher duration of illness at the time of diagnosis, and those who received additional intravenous immunoglobulin showed a significantly higher frequency of giant coronary aneurysms.


One of the main factors associated with the development of giant coronary aneurysms was the delay in the diagnosis of Kawasaki disease. This finding highlights the importance of maintaining a high suspicion of the disease, which would enable an early diagnosis and prompt treatment and decrease the risk for developing giant coronary aneurysms.


Corresponding author

Correspondence to: L. M. Garrido-García, MD, MSc, Cardiology Department, National Institute of Paediatrics, Av. Insurgentes Sur 3700-C, Colonia Insurgentes Cuicuilco, Mexico City, 04530, Mexico. Tel: +52 551 353 7829; Fax: + 52 55 10840900; E-mail:


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1. Newburger, JW, Takahashi, M, Gerber, MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease. Circulation 2004; 110: 27472771.
2. Son, MBF, Newburger, JW. Kawasaki disease. Pediatr Rev 2013; 34: 151161.
3. Newburger, JW, Takahashi, M, Burns, JC. Kawasaki disease. JACC 2016; 67: 17381749.
4. Makino, N, Nakamura, Y, Yashiro, M, et al. Descriptive epidemiology of Kawasaki disease in Japan, 2011–2012: from the results of the 22nd Nationwide survey. J Epidemiol 2015; 25: 239245.
5. Sudo, D, Monobe, Y, Yashiro, M, et al. Case-control study of giant coronary aneurysms due to Kawasaki disease: the 19th nationwide survey. Pediatr Int 2010; 52: 790794.
6. Nakamura, Y, Yashiro, M, Oki, I, et al. Giant coronary aneurysms due to Kawasaki disease: a case-control study. Pediatr Int 2002; 44: 254258.
7. Nakamura, Y, Yashiro, M, Uehara, R, et al. Case-control study of giant coronary aneurysms due to Kawasaki disease. Pediatr Int 2003; 45: 410413.
8. Nakamura, Y, Yashiro, M, Uehara, R, et al. Use of laboratory data to identify risk factors of giant coronary aneurysms due to Kawasaki disease. Pediatr Int 2004; 46: 3338.
9. Dallaire, F, Dahdah, N. New equations and a critical appraisal of coronary artery Z scores in healthy children. J Am Soc Echocardiogr 2011; 24: 6074.
10. Manlhiot, C, Millar, K, Golding, F, McCrindle, BW. Improved classification of coronary artery abnormalities based only on coronary artery z-scores after Kawasaki disease. Pediatr Cardiol 2010; 31: 242249.
11. Uehara, R, Belay, ED. Epidemiology of Kawasaki disease in Asia, Europe, and the United States. J Epidemiol 2012; 22: 7985.
12. Budnik, OI, Hirsch, BT, Fernández, CC, Yánez, PL, Zamorano, RJ. Enfermedad de Kawasaki: una serie clínica. Rev Chil Infect 2011; 28: 416422.
13. Martínez-Ruíz, M, del Castillo, MF, Borque, AC, et al. Incidencia y características clínicas de la enfermedad de Kawasaki. Ann Pediatr (Barc) 2003; 59: 323327.
14. Garrido-García, LM, Soto-Blanquel, JL, Espinosa-Rosales, FJ. Enfermedad de Kawasaki: cuadro clínico, exámenes de laboratorio y lesiones coronarias. Acta Pediatr Mex 2015; 36: 314321.
15. Kim, J-J, Hong, YM, Yun, SW, et al. Assessment of risk factors for Korean children with Kawasaki disease. Pediatr Cardiol 2012; 33: 513520.
16. Lee, J, Kim, GB, Kwon, BS, Bae, EJ, Noh, CI. Two cases of super-giant coronary aneurysms after Kawasaki disease. Korean Circ J 2014; 44: 5458.
17. Schroh, AM, Domínguez, P, Laghezza, LB, et al. Enfermedad de Kawasaki: afección cardiaca durante la infancia. Rev Esp Cardiol 2006; 59: 387390.
18. Morikawa, Y, Ohashi, Y, Harada, K, et al. Coronary risks after high-dose gamma-globulin in children with Kawasaki disease. Pediatr Int 2000; 42: 464469.
19. Ha, KS, Jang, GY, Lee, JH, et al. Incomplete clinical manifestation as a risk for coronary artery abnormalities in Kawasaki disease: a meta-analysis. Eur J Pediatr 2013; 172: 343349.
20. Lin, MC, Hsu, CM, Fu, YC. Giant coronary aneurysms developed in a child of Kawasaki disease with only 3 days of fever. Cardiol Young 2010; 20: 339341.
21. Samada, K, Shiraishi, H, Sato, A, Momoi, MY. Grown-up Kawasaki disease patients who have giant coronary aneurysms. World J Pediatr 2010; 6: 3842.
22. Al-Mashham, Y, Sinclair, BG, Duncan, WJ. Giant coronary arterial aneurysms and thrombosis in an infant with Kawasaki disease. Cardiol Young 2006; 16: 510.
23. Patil, S, Shirodkar, S, Pinto, RJ, Dalvi, B. Giant coronary artery aneurysm with a thrombus secondary to Kawasaki disease. Ann Pediatr Cardiol 2008; 1: 5961.
24. Lega, JC, Bozio, A, Cimaz, R, et al. Extracoronary echocardiographic findings as predictors of coronary artery lesions in the initial phase of Kawasaki disease. Arch Dis Child 2012; 0: 16.



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