A Child with Kawasaki Disease and Coronary Artery Aneurysm during Acute Epstein-Barr Virus Infection: A Closer Look at Immunopathogenesis

Kawasaki disease (KD) is the most common childhood cause of acquired coronary artery disease in the developed world. The diagnosis is often challenging, and atypical presentations may be associated with increased morbidity and mortality. We describe an 18-month-old toddler boy who developed clinical manifestations of KD with coronary artery aneurysmal dilatation and autoimmune hemolytic anemia during Epstein-Barr virus infection. The child had evidence of polyclonal activation of B cells that caused serological tests to be positive for different infections. Our case suggests an unusual immunological response to primary Epstein-Barr virus infection may lead to KD manifestation and coronary artery damage.