Case Report: Long-term follow-up of multiple giant coronary artery aneurysm associated with multisystem inflammatory syndrome in children
IntroductionMultisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition that emerged during the COVID-19 pandemic. While most coronary artery abnormalities in MIS-C are transient, the potential for persistent or progressive coronary aneurysms remains unclear. This report pr...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1549321/full |
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| Summary: | IntroductionMultisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition that emerged during the COVID-19 pandemic. While most coronary artery abnormalities in MIS-C are transient, the potential for persistent or progressive coronary aneurysms remains unclear. This report presents the long-term follow-up of a pediatric MIS-C case with multiple giant coronary artery aneurysms.Case presentationA 4-year-old boy presented with 13 days of persistent fever during the COVID-19 pandemic. MIS-C was diagnosed based on high-grade fever, markedly elevated inflammatory markers, recent SARS-CoV-2 exposure, and coronary artery involvement on echocardiography. The patient showed rapid clinical improvement following treatment with intravenous immunoglobulin, corticosteroids, aspirin, and enoxaparin. Cardiac catheterization at 8 weeks confirmed multiple giant aneurysms in the right and left coronary arteries. He remained asymptomatic and was followed with echocardiography and ECG every 3 months. After 30 months, repeat catheter angiography revealed persistent giant aneurysms, though with slightly reduced dimensions.ConclusionThis case highlights that multiple giant coronary artery aneurysms associated with MIS-C may persist even after long-term follow-up, despite clinical and laboratory improvement. It underscores the need for extended cardiac monitoring and prolonged antithrombotic therapy in children with severe coronary involvement. |
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| ISSN: | 2296-2360 |