{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:37:00Z","timestamp":1760189820478,"version":"3.28.0"},"reference-count":11,"publisher":"Texas Heart Institute Journal","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022]]},"abstract":"Kawasaki disease, an acute febrile illness, can cause vasculitis in the coronary arteries. It is the chief acquired cause of myocardial infarction and sudden cardiac death in infants, children, and young adults in developed countries. We report a case of chronic, silent Kawasaki disease complicated by multivessel thrombosis in a 39-year-old Egyptian woman. The patient presented with progressive, unstable angina but was otherwise asymptomatic and at negligible risk of ischemic heart disease. Coronary angiograms showed critical arterial stenosis with multiple aneurysms. During revascularization surgery, the patient's harvested left internal mammary artery was found to have occlusive lesions and aneurysmal areas that made it unfit for bypass grafting, and subsequent histopathologic examination revealed features characteristic of chronic Kawasaki disease\u2013associated systemic vasculitis.<\/jats:p>\n We think that this is only the second report of Kawasaki disease in the Arabian Mediterranean region. In addition to the patient's case, we discuss the epidemiology and management of Kawasaki disease, in hopes of increasing clinicians' awareness.<\/jats:p>","DOI":"10.14503\/thij-20-7261","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T14:27:50Z","timestamp":1649946470000},"source":"Crossref","is-referenced-by-count":1,"title":["Silent Kawasaki Disease Affecting Multiple Coronary Arteries in a 39-Year-Old Egyptian Woman"],"prefix":"10.14503","volume":"49","author":[{"given":"Hamdy","family":"Singab","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gamal","family":"Sami","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Tag El Sabah","sequence":"additional","affiliation":[{"name":"Department of Pathology, Misr University for Science and Technology, 6th of October City, Giza, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5628","reference":[{"issue":"17","key":"i1526-6702-49-2-e207261-b1","series-title":"Circulation","first-page":"e927","article-title":"Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association [published erratum appears in Circulation 2019;140(5):e181\u20134]","volume":"135","year":"2017","unstructured":"McCrindle\n BW,\n \n \n Rowley\n AH,\n \n \n Newburger\n JW,\n \n \n Burns\n JC,\n \n \n Bolger\n AF,\n \n \n Gewitz\n M,\n \n \n .\n\t\t\t\t\tDiagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association [published erratum appears in Circulation 2019;140(5):e181\u20134].\n\t\t\t\t\tCirculation2017;135(17):e927\u201399."},{"issue":"2","key":"i1526-6702-49-2-e207261-b2","series-title":"J Epidemiol","first-page":"79","article-title":"Epidemiology of Kawasaki disease in Asia, Europe, and the United States","volume":"22","year":"2012","unstructured":"Uehara\n R,\n \n \n Belay\n ED.\n \n \n Epidemiology of Kawasaki disease in Asia, Europe, and the United States.\n\t\t\t\t\tJ Epidemiol2012;22(2):79\u201385."},{"issue":"1","key":"i1526-6702-49-2-e207261-b3","series-title":"J Pediatr","first-page":"126","article-title":"Epidemiology of Kawasaki disease: prevalence from national database and future trends projection by system dynamics modeling","volume":"163","year":"2013","unstructured":"Huang\n SK,\n \n \n Lin\n MT,\n \n \n Chen\n HC,\n \n \n Huang\n SC,\n \n \n Wu\n MH.\n \n \n Epidemiology of Kawasaki disease: prevalence from national database and future trends projection by system dynamics modeling.\n\t\t\t\t\tJ Pediatr2013;163(1):126\u201331.e1."},{"issue":"1","key":"i1526-6702-49-2-e207261-b4","series-title":"BMC Pediatr","first-page":"295","article-title":"Kawasaki shock syndrome in an Arab female: case report of a rare manifestation and review of literature","volume":"19","year":"2019","unstructured":"Nugud\n AA,\n \n \n Nugud\n A,\n \n \n Wafadari\n D,\n \n \n Abuhammour\n W.\n \n \n Kawasaki shock syndrome in an Arab female: case report of a rare manifestation and review of literature.\n\t\t\t\t\tBMC Pediatr2019;19(1):295."},{"issue":"4","key":"i1526-6702-49-2-e207261-b5","series-title":"J Infect Dis","first-page":"499","article-title":"Association between a novel human coronavirus and Kawasaki disease","volume":"191","year":"2005","unstructured":"Esper\n F,\n \n \n Shapiro\n ED,\n \n \n Weibel\n C,\n \n \n Ferguson\n D,\n \n \n Landry\n ML,\n \n \n Kahn\n JS.\n \n \n Association between a novel human coronavirus and Kawasaki disease.\n\t\t\t\t\tJ Infect Dis2005;191(4):499\u2013502."},{"issue":"2","key":"i1526-6702-49-2-e207261-b6","series-title":"Am J Cardiovasc Pathol","first-page":"218","article-title":"Pathological features of Kawasaki disease (mucocutaneous lymph node syndrome)","volume":"1","year":"1987","unstructured":"Landing\n BH,\n \n \n Larson\n EJ.\n \n \n Pathological features of Kawasaki disease (mucocutaneous lymph node syndrome).\n\t\t\t\t\tAm J Cardiovasc Pathol1987;1(2):218\u201329."},{"issue":"3","key":"i1526-6702-49-2-e207261-b7","series-title":"Med Hypotheses","first-page":"642","article-title":"Kawasaki disease may be a hyperimmune reaction of genetically susceptible children to variants of normal environmental flora","volume":"69","year":"2007","unstructured":"Lee\n KY,\n \n \n Han\n JW,\n \n \n Lee\n JS.\n \n \n Kawasaki disease may be a hyperimmune reaction of genetically susceptible children to variants of normal environmental flora.\n\t\t\t\t\tMed Hypotheses2007;69(3):642\u201351."},{"issue":"6","key":"i1526-6702-49-2-e207261-b8","series-title":"Catheter Cardiovasc Interv","first-page":"809","article-title":"Arterial complications associated with cardiac catheterization in pediatric patients with a previous history of Kawasaki disease","volume":"73","year":"2009","unstructured":"Gurofsky\n RC,\n \n \n Sabharwal\n T,\n \n \n Manlhiot\n C,\n \n \n Redington\n AN,\n \n \n Benson\n LN,\n \n \n Chahal\n N,\n \n \n McCrindle\n BW.\n \n \n Arterial complications associated with cardiac catheterization in pediatric patients with a previous history of Kawasaki disease.\n\t\t\t\t\tCatheter Cardiovasc Interv2009;73(6):809\u201313."},{"issue":"1","key":"i1526-6702-49-2-e207261-b9","series-title":"Int J Rheum Dis","first-page":"31","article-title":"Histopathological aspects of cardiovascular lesions in Kawasaki disease","volume":"21","year":"2018","unstructured":"Takahashi\n K,\n \n \n Oharaseki\n T,\n \n \n Yokouchi\n Y.\n \n \n Histopathological aspects of cardiovascular lesions in Kawasaki disease.\n\t\t\t\t\tInt J Rheum Dis2018;21(1):31\u20135."},{"issue":"1","key":"i1526-6702-49-2-e207261-b10","series-title":"J Am Coll Cardiol","first-page":"253","article-title":"Sequelae of Kawasaki disease in adolescents and young adults","volume":"28","year":"1996","unstructured":"Burns\n JC,\n \n \n Shike\n H,\n \n \n Gordon\n JB,\n \n \n Malhotra\n A,\n \n \n Schoenwetter\n M,\n \n \n Kawasaki\n T.\n \n \n Sequelae of Kawasaki disease in adolescents and young adults.\n\t\t\t\t\tJ Am Coll Cardiol1996;28(1):253\u20137."},{"issue":"1","key":"i1526-6702-49-2-e207261-b11","series-title":"Nat Rev Cardiol","first-page":"51","article-title":"So hard to say goodbye: transition from paediatric to adult cardiology care","volume":"11","year":"2014","unstructured":"Kovacs\n AH,\n \n \n McCrindle\n BW.\n \n \n So hard to say goodbye: transition from paediatric to adult cardiology care.\n\t\t\t\t\tNat Rev Cardiol2014;11(1):51\u201362."}],"container-title":["Texas Heart Institute 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