Key result
Combination therapy with clopidogrel, abciximab, aspirin, enoxaparin, and alteplase successfully stabilized coronary aneurysms and resolved thrombi in an infant with incomplete Kawasaki disease.
Why the study?
Does combination thrombolytic and anti-platelet therapy resolve coronary thrombi and stabilize aneurysms in an infant with incomplete Kawasaki disease?
Case Report (n=1)
Does combination thrombolytic and anti-platelet therapy resolve coronary thrombi and stabilize aneurysms in an infant with incomplete Kawasaki disease?
Combination thrombolytic and anti-platelet therapy, including clopidogrel, abciximab, and aspirin, successfully resolved coronary thrombi and stabilized aneurysms in an infant with incomplete Kawasaki disease.
Answers are grounded in this paper and cite their sources.
May support multi-agent antithrombotic regimens in infantile Kawasaki coronary complications; hypothesis-generating and should not yet change practice.
A 3-month-old infant was transferred to our facility with persistent fever and concerns for septic shock. A 2-D echocardiogram revealed multiple coronary aneurysms and axillary and coronary artery thrombi, and a diagnosis of incomplete Kawasaki disease (KD) was established. Aggressive therapies including intravenous immunoglobulins, enoxaparin, abciximab, aspirin, and alteplase were used to decrease the size of the coronary aneurysms and inhibit further thrombus formation. After minimal change in the size of coronary aneurysms and in thrombus formation, clopidogrel was added. Approximately 2 weeks after initiation of these therapies, a decrease in the coronary aneurysm size was noted with no signs of thrombus. This case documents successful use of thrombolytic and combination anti-platelet agents (i.e., clopidogrel, abciximab, and aspirin) in an infant with KD and cardiovascular sequelae.
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Johnson et al. (2008) conducted a case report in Incomplete Kawasaki disease with coronary aneurysms and thrombosis (n=1). Combination thrombolytic and anti-platelet therapies was evaluated on Resolution of thrombus and stabilization of coronary aneurysm size. Combination therapy with clopidogrel, abciximab, aspirin, enoxaparin, and alteplase successfully stabilized coronary aneurysms and resolved thrombi in an infant with incomplete Kawasaki disease.
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