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Lymph-node-first Kawasaki disease and giant coronary artery aneurysm
  1. Bazlin Ramly
  1. Paediatric Department, University Hospital Waterford, Waterford, Ireland
  1. Correspondence to Dr Bazlin Ramly, pushing.daisies84{at}


A 8-year-old Irish ethnicity girl presented with 3 days of fever with right-sided neck swelling which was first thought as acute tonsillitis with right-sided lymphadenitis. She was started on intravenous antibiotics. At day 7 of illness, she was diagnosed to have Kawasaki disease with clinical and biochemical evidence. Echocardiogram at day 9 of illness and subsequently CT cardiac angiogram performed revealed giant aneurysm at the right coronary artery with non-obstructing thrombus seen. The patient then commenced on clopidogrel and continued with a regular dose of aspirin. Due to the evidence of thrombus with a giant coronary aneurysm, she was also put on long-term warfarin therapy with regular monitoring of her international normalised ratio to be kept at the range of 2.0–3.0.

  • cardiovascular system
  • warfarin therapy
  • paediatrics
  • ultrasonography
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  • Contributors Dr BR is the main author for the case report combining the data and interpreting them together with the consultant in charge of the patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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