Idiopathic multiple systemic aneurysms in a child.
A 3-year-old child had ischemia of the left-sided upper extremity secondary to embolic disease. Arteriography showed multiple idiopathic saccular aneurysms of the left subclavian artery. Coronary arteriograms were normal. Cerebral arteriography showed ectasia of the right common carotid artery, and abdominal aortography, aneurysms of the splenic and phrenic arteries. The patient underwent brachial artery embolectomy, proximal and distal aneurysm ligation, and placement of a carotid to axillary artery polytef bypass graft. Microscopic analysis indicated intimal proliferation, normal elastic tunica media vasorum, and no evidence of an inflammatory process. Electron microscopy showed no evidence of rickettsiae. The patient's clinical appearance was similar but not identical to that of Kawasaki disease, Takayasu's disease, or periarteritis nodosa. Workup of the patient and subsequent surgical exploration failed to demonstrate a definitive cause.