Multiple Giant Coronary Artery Aneurysms in a Pediatric Patient with Granulomatosis with Polyangiitis

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Pediatric Cardiol. 2022 Apr 9 doi: 10.1007/s00246-022-02875-3. Online for print.

ABSTRACT

Granulomatosis with polyangiitis (GPA) is characterized by necrotizing vasculitis of small and medium-sized blood vessels and is rare in pediatric patients. Cardiac manifestations in pediatric patients with GPA are extremely uncommon, with only two known reported cases associated with coronary artery aneurysms (Rehani and Nelson in Pediatrics 147:e20200932, 2021, https://doi.org/10.1542/peds.2020-0932; Aghaei Moghadam et al. in Case Rep Cardiol 2020:3417910, 2020, https://doi.org/10.1155/2020/3417910). We report a case of a 14-year-old male who presented with a 1-month history of fatigue and shortness of breath. He was eventually found to have multiple giant coronary aneurysms in both the left and right coronary arteries, including a giant aneurysm in the posterior descending; this has not been reported before. The case highlights the need for complete multimodal imaging of the coronary arteries in patients with GPA.

PMID:35396672 | DOI: 10.1007/s00246-022-02875-3