Unresolved Coronary artery aneurysms in an adolescent with multisystemic inflammatory syndrome in children associated with SARS-CoV-2 infection- What happens in the long term?- Case report

Chaitra Govardhan; Poornima Ragavaiah Naidu; Fulton D'Souza

doi:10.18203/2349-3291.ijcp20251892

Authors

Chaitra Govardhan Department of Pediatrics, St. John’s Medical College and Hospital, Bangalore, Karnataka, India
Poornima Ragavaiah Naidu Department of Pediatrics, St. John’s Medical College and Hospital, Bangalore, Karnataka, India
Fulton D'Souza Department of Pediatrics, St. John’s Medical College and Hospital, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20251892

Keywords:

Coronary artery aneurysm, Case report, Long-term outcome, MIS-C

Abstract

MIS-C, a well-known association with SARS-CoV-2 infection, has been a topic of significant interest. It presents with Kawasaki-like illness along with coronary artery dilation or aneurysms. In this report, we describe a particularly intriguing case of an adolescent with MIS-C presenting with coronary artery aneurysms persisting at the end of a 6-month follow-up, underscoring the importance of this condition. An 11-years-old adolescent female presented with fever, livedoid vasculitis rash over lower limbs, abdominal pain and breathlessness. Diagnosis of MIS-C was established based on the clinical findings, elevated inflammatory markers and positive SARS-CoV-2 IgG antibodies. Echocardiogram evidenced myocardial dysfunction with moderate pericardial effusion and coronary aneurysm. She was treated with intravenous immunoglobulins, steroids and aspirin. Serial follow-up until 6 months showed persisting skin changes and coronary aneurysms with normalized inflammatory markers. MIS-C and its related long-term outcome have been well recognized; however, longer follow-up is not just essential, but urgent in understanding this known yet novel condition.

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