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Infantile periarteritis nodosa or mucocutaneous lymph node syndrome. A report on four cases and diagnostic
Insights
Childhood coronary artery aneurysms, often linked to infantile periarteritis nodosa (IPN), may be caused by mucocutaneous lymph node syndrome (MLNS). These conditions share features, suggesting a single disease entity with risks of sudden cardiac death.
Area of Science:
- Pediatric Cardiology
- Rheumatology
- Pathology
Background:
- Coronary artery aneurysms in children are rare, typically associated with infantile periarteritis nodosa (IPN).
- Mucocutaneous lymph node syndrome (MLNS), first described by Kawasaki in 1967, is prevalent in Japan and frequently affects coronary arteries and myocardium.
- The clinical and pathological overlap between MLNS and IPN suggests they may represent a single disease entity.
Abstract:
Coronary artery aneurysm in childhood is a rare disease and has in most cases been ascribed to infantile periarteritis nodosa (IPN). In recent years a mucocutaneous lymph node syndrom (MLNS) has been found almost exclusively in Japan first described by Kawasaki 1967; this disease frequently involves the coronary arteries and myocardium. Four cases with coronary aneurysms are presented from Sweden and seem to be first described from Scandinavia. Three of these patients died a sudden death with cardiac arrest. Since MLNS and IPN have identical clinical and pathological features, we suggest that MLNS and IPN constitute a pathologic entity and that to separate them on a clinical or histological basis is nonsensical. The risk of coronary aneurysm and possible sudden death must be considered in patients with uncharacteristic symptoms including prolonged fever, conjunctivitis, exanthema, lesions in the oral mucosa, elevated sedimintation rate, and leukocytosis.