Abstract
Anerysm formation with inflammatory change is a common pathologic feature of middle sized artery in Kawasaki disease. While we have been investigating more than one hundred autopsy cases, we found strange coronary arterioles of the epicardial space in a case of Kawasaki disease (male, 4 month of age, died in the 38th clinical day), which showed many slit-like pits or capillary branchings directly to the capillaries in the adventitia. We have never met such lesion in other cases of Kawasaki disease or in other vasculitis syndromes. To investigate the nature of these lesions, serial three-dimensional histologic reconstructive study of one of the arterioles together with some immunological studies were performed. Within 0.6 mm in length, there are 14 pits and 14 branchings directly to the adventitial capillaries and 2 true branchings. Luminal surface including pits and branchings is preserved with endothelial layer. There is no inflammatory change. Vascular lesion of Kawasaki disease is characterized by the early vascular lesion especially on capillaries and later arteritis with aneurysm formation. However, how small vascular lesions convert to larger arterial lesion especially on aneurysm formation is still mystery. We speculate that these lesions are new vascular formation directly from the artery and therefore “arterial angiogenesis”. On the point of increase of endothelial surface, angiogenesis and aneurysmal formation are similar, although real features are very different. Vascular lesion of Kawasaki disese should be investigated suggesting that there is angiogenesis behind.
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Masuda, H., Hong, X., Kawamura, K. et al. Arterial Angiogenesis in Kawasaki Disease. A Histologic Three-dimensional Reconstructive Study of a Small Artery with Many Branches. Pediatr Res 53, 174 (2003). https://doi.org/10.1203/00006450-200301000-00122
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DOI: https://doi.org/10.1203/00006450-200301000-00122