A CASE OF RELAPSING KAWASAKI-DISEASE AND REVIEW OF THE LITERATURE

A review of the literature was carried out on the occasion of one case of Kawasaki disease in a small infant aged 3 months which relapsed 17 years later. Kawasaki disease is oi unknown aetiology and mainly affe cts children under 5 years of age. It is manifested as a necrotizing v asculitis with aneurysms of the coronary arteries and the proximal med ium size arteries. One hundred and fifteen thousend eases have been re ported up to the present date, an incidence of 6-11/100000 children. T he evidence of coronary aneurysms range from 20-30%, while peripheral aneurysms are rare. Eighteen cases of peripheral ischemia have been re ported in the international literature. The diagnosis is clinical and treatment remains symptomatic (anti-inflammatory and anticoagulant). T hrombolytic and anticoagulant management is applied in acute heart att ack, and surgical bypass in chronic ischemia. Reversion of the aneurys ms is observed in 60% of the cases, while relapse of the disease is po ssible pars or decades later. Death is due to thrombosis of the corona ry or rupture of the coronary or distal aneurysm. For this reason, reg ular fellow-up of the patients is recommended, according to the guidel ines for long-term management of patients with Kawasaki disease.