[Pathology of Kawasaki disease]

Kawasaki disease (KD), an acute febrile disorder with systemic arteritis predominantly in the coronary arteries, is the leading cause of acquired heart disease in childhood. Since many KD patients have reached adulthood, the question arises whether post-KD arteritis lesions can become a risk factor for atherosclerosis of coronary arteries. We immunohistochemically investigated post-KD coronary arteries obtained from autopsied patients. All coronary arteries with KD revealed marked and diffuse intimal proliferation, and occasional sites revealed aneurysmal formation. Coronary arteries, with intervals more than 5 years after the onset, showed distinct atherosclerotic changes of intimal lesions associated with dedifferentiation of smooth muscle cells. These results strongly suggest that post-KD intimal lesions can become atherosclerotic plaques.