Coronary artery dilatation in Systemic Lupus Erythematosus

The echocardiographic finding of dilated coronary arteries has long been associated with Kawasaki disease. When this finding is encountered in clinical practice, Kawasaki disease is almost always the first consideration of Pediatric Cardiologists. In this manuscript we present the case of an 11-year-old girl found to have coronary artery dilatation in the setting of lymphadenopathy and fever initially presumed to be secondary to Kawasaki disease, but was later revealed to be secondary to Systemic Lupus Erythematosus. The phenomenon of coronary dilatation with Lupus and other autoimmune diseases has been rarely described previously in the literature, and this case highlighted the importance of considering autoimmune phenomena in the workup of coronary artery dilatation. Current recommendations favor echocardiography as part of the initial workup for autoimmune diseases such as Lupus, and further studies are needed to elucidate the ultimate relationship between autoimmune diseases and coronary artery dilatation.