| Ultrastructural characteristics of myocardial and coronary microvascular lesions in Kawasaki disease. | |
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MedLine Citation:
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PMID: 10388599 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Kawasaki disease (KD) is an acute febrile mucocutaneous lymph node syndrome with multisystemic vasculitis affecting mainly infants and children. Although several studies on cardiovascular lesions in KD have been done at the light microscopic level, the ultrastructural characteristics and incidences of these lesions have not been well defined. In order to investigate the myocardial and coronary microvascular sequelae in KD, we performed an ultrastructural study on endomyocardial biopsy specimens obtained during follow-up from 54 patients who had typical clinical manifestations of KD, of whom 47 had associated coronary aneurysms as demonstrated by coronary arteriography (CAG) or two-dimensional echocardiography in the acute or healed stage. The average age of onset was 2.2 years old and the duration of illness was from 2 months to 23 years. Follow-up CAG showed that the coronary aneurysms persisted in 33 of the 47 patients (8 with associated stenosis) and resolved in the remaining 14 patients. Ultrastructurally, the myocardial changes revealed hypertrophy, various degrees of degeneration, proliferation and abnormality of mitochondria, infiltration of a small number of lymphocytes, and fibrosis. The coronary microvascular lesion was characterized by microvascular dilatation, endothelial cell injury, platelet aggregation with thrombosis, and stenotic lumen with thickened walls in the small arterioles. It persisted after convalescent stage even up to 23 years and closely correlated with the myocardial sequelae. Moreover, significantly increased incidences of myocardial and coronary microvascular lesions were found in patients with coronary artery lesion. These findings suggest the coronary microvascular lesion as a possible underlying factor of persistent sequelae in KD. |
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Authors:
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A M Liu; M Ghazizadeh; Z Onouchi; G Asano |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Microvascular research Volume: 58 ISSN: 0026-2862 ISO Abbreviation: Microvasc. Res. Publication Date: 1999 Jul |
Date Detail:
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Created Date: 1999-09-02 Completed Date: 1999-09-02 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0165035 Medline TA: Microvasc Res Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 10-27 Citation Subset: IM |
Copyright Information:
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Copyright 1999 Academic Press. |
Affiliation:
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Central Institute for Electron Microscopic Researches, Nippon Medical School, Tokyo, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Age of Onset Cardiomyopathy, Hypertrophic / etiology, pathology Child Child, Preschool Convalescence Coronary Aneurysm / etiology, pathology Coronary Angiography Coronary Disease / etiology, pathology Coronary Vessels / pathology, ultrastructure* Dilatation, Pathologic Endocardium / ultrastructure* Endomyocardial Fibrosis / etiology, pathology Female Follow-Up Studies Humans Infant Japan / epidemiology Male Mitochondria, Heart / ultrastructure Mucocutaneous Lymph Node Syndrome / complications, epidemiology, pathology* Myocarditis / etiology, pathology |
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