Abstract
To evaluate coronary arterial changes found in most Kawasaki disease (KD) patients who recover without aneurysms, histopathologial observation was performed using autopsy KD patients. Materials and Methods: Fifteen KD autopsy patients without coronary artery aneurysms by macroscopical observation, ranged from 6 days to 14 years after the onset of illness, were used in this study. Coronary arteries were fixed in 10% formalin and embedded in paraffin. Hematoxylin and eosin, Elastica van Gieson and azan-Mallory stain were performed for routine histological examination. Results:Acute phase: In coronary arteries of the patients who died on 6th day after the onset, a few inflammatory cells were observed in the intima and adventitia. In coronary arteries of 9th to 13th illness day, histological findings varied from no inflammation unto marked panarteritis showing severe inflammatory cells infiltration and disruption of internal elastic lamina. After 17th day, inflammation became much milder than former lesions, and the lesions showed subsiding tendency. The causes of death of these patients were myocarditis, valvulitis or interstitial pneumonia. Remote phase: All patients died of causes other than sequelae of KD. In five of six patients, scarring of arteritis such as concentric intimal thickening and extension of internal elastic lamina was observed in coronary arteries. However, remarkable change was not seen in one patient. Summary: The degree of acute inflammation in coronary arteries varied in each patient. Especially, we must point out the existence of the patients having no inflammation at coronary arteries even in acute phase. In addition, there was a case without apparent arterial change also in remote phase. In this patient, it is suggested that no or very slight inflammation in coronary arteries had occurred at acute phase.
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Takahashi, K., Oharaseki, T., Naoe, S. et al. Histopathological Study on Non-Aneurysmal Coronary Arteries in Kawasaki Disease. Pediatr Res 53, 186 (2003). https://doi.org/10.1203/00006450-200301000-00194
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DOI: https://doi.org/10.1203/00006450-200301000-00194