تغيير شكل گازانبري گذرا و منتشر ناخن‌هاي دست‌وپا در يك شيرخوار سه‌ماهه با بيماري كاوازاكي و درگيري شديد عروق كرونر

PINCER NAIL DEFORMITY IN A THREE-MONTH-OLD INFANT WITH KAWASAKI DISEASE AND CORONARY ARTERIES INVOLVEMENT

تغيير شكل گازانبري (Pincer nail deformity) در بيماري كاوازاكي بندرت اتفاق مي‌افتد و وقوع همزمان آن با آنوريسم در عروق كرونر بسيار نادر مي‌باشد (1،2). در اين مقاله، شيرخوار سه‌ماهه‌اي معرفي مي‌شود كه به علت تب و بي‌حالي و عدم شير خوردن بستري گرديد. در طي بستري، دچار تغيير شكل گازانبري منتشر و گذرا در تمام ناخن‌هاي دست‌وپا گرديد كه بعد از چهار روز و همزمان با درمان بيماري كاوازاكي بهبودي كامل يافت. همچنين در مرحله تحت حاد دچار آنوريسم در عروق كرونر چپ و راست گرديد. در بررسي‌هاي سرپايي يك سال بعد آنوريسم در عروق كرونر كاملاً بهبود يافته بود.

Background & Aims: Kawasaki disease is an acute multisystem vasculitis that primarily occurs in infants and young children. Pincer nail deformity is not from classic signs of Kawasaki disease and its occurrence with Kawasaki disease is rare, and concomitant occurrence of it with coronary artery aneurysm in Kawasaki disease is rarer. Case report: A three-month-old infant was admitted to hospital with history of high fever, poor feeding and ill appearing from three days before. In the 4th day after admission, diffuse pincer nail deformity appeared in all nails of hands and feet. This deformity was transient and after therapy of Kawasaki disease with IVIG, it completely resolved. In sub-acute phase, after resolution of fever, severe aneurysms appeared in right and left coronary arteries, so therapy with warfarin and aspirin were given for patient. In outpatient follow up one year later, fortunately all aneurysms were completely resolved. Conclusion: Pincer nail deformity could be a sign of atypical Kawasaki disease and appearance of this deformity in a patient with Kawasaki disease can be a risk factor for coronary artery involvement.