Coronary Artery Aneurysms as a Feature of Granulomatosis With Polyangiitis

Granulomatosis with polyangiitis is an antineutrophil cytoplasmic antibody–associated vasculitis that primarily affects small vessels. The disease typically the respiratory tract and kidneys but has also been known to involve gastrointestinal tract, genitourinary thyroid, liver. Cardiac involvement rare. Coronary artery aneurysms (CAAs) are extremely uncommon finding, only 1 reported case in adult patient no pediatric cases date. Here, we report unique of a child granulomatosis who initially presented fever unknown origin pulmonary renal symptoms cardiac complaints. An echocardiogram revealed severe bilateral fusiform CAAs. Because high risk mortality posed by severity her disease, was managed intensive induction immunosuppression steroids, rituximab, cyclophosphamide. She maintained on aspirin, warfarin improved function change