SUDDEN CARDIAC-ARREST IN INFANTILE SYSTEMIC VASCULITIS

A 23 month old boy was admitted to hospital because of anemia, mainly truncal rash and unclear pain. Previously he had shown fever, conjunct ivitis and desquamations of hands and feet. Laboratory findings were m oderate leucocytosis, thrombocytosis, anemia, and an elevation of ESR and gamma globulins. No bacterial infection was found. The ECG showed signs of a myocardial ischemia. The sonography of the heart detected a n aneurysm of the left coronary artery. The boy died of a sudden cardi ac arrest. The autopsy verified the diagnosis of Kawasaki-syndrome and revealed two coronary aneurysms blocked by thrombosis and a necrotic panarteriitis. Discussion: The main cause of death in Kawasaki disease is myocardial infarction resulting from thrombotic occlusion in a cor onary aneurysm. This case is of interest because the infantile systemi c vasculitis is associated with an acute Paravo B 19 virus infection, which so far has been reported in only one case.