A very ill 3-year-old child is brought into the emergency room with a fever. On physical examination, the child has large cervical lymph nodes and a desquamating skin rash that involves the palms, soles, and mouth. This child should be monitored for the development of which of the following conditions?
Correct Answer: Coronary aery aneurysm
Description: The child has Kawasaki's syndrome (mucocutaneous lymph node syndrome). In this disorder, small, medium, and large aeries are affected, with transmural inflammation and variable necrosis. About 20% of affected children have damage to the coronary vessels; some develop coronary aery aneurysms. In 1-2% of cases, sudden death may occur from aneurysm rupture or thrombosis producing infarction.Good to know:Abdominal aoic aneurysms are associated with atherosclerosis.Aneurysms of aoic root are usually associated with syphilis.Berry aneurysms are caused by congenital defects in the vessel wall, and are associated with polycystic kidney disease. Ref: Waller B.F. (2011). Chapter 55. Nonatherosclerotic Coronary Hea Disease. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e.
Category:
Pathology
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