Kawasaki disease is an acute self-limiting vasculitis of medium-sized arteries in children. The most feared complication is:
- A Renal artery stenosis causing renovascular hypertension
- B Coronary artery aneurysm formation (risk of thrombosis and myocardial infarction) ✓
- C Aortic dissection due to medial necrosis
- D Pulmonary arterial hypertension
Explanation
Kawasaki disease causes acute necrotizing inflammation of medium vessels; coronary arteries are the most commonly affected visceral vessels due to their thin adventitia and limited vasa vasorum. Without treatment with IVIG and aspirin, up to 25% develop coronary artery aneurysms (z-score ≥2.5). Giant aneurysms (>8 mm diameter) are at high risk for thrombosis and myocardial infarction. Renal artery stenosis is a complication of Takayasu arteritis (large vessel). Aortic dissection is seen in Marfan syndrome and hypertension. Pulmonary hypertension is not a primary complication of Kawasaki disease.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.