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Endomyocardial biopsy in children with Kawasaki disease
Insights
Kawasaki Disease (KD) can cause lasting myocardial changes, even without coronary artery lesions. These persistent histopathological abnormalities suggest a potential risk of developing cardiomyopathy in some patients.
Area of Science:
- Cardiovascular Pathology
- Pediatric Cardiology
- Rheumatology
Background:
- Kawasaki Disease (KD) is an acute febrile illness affecting young children.
- Coronary artery lesions (CAL) are a known complication of KD.
- The long-term impact of KD on myocardial health requires further investigation.
Purpose of the Study:
- To investigate the myocardial histopathology in children with Kawasaki Disease.
- To correlate histopathological findings with the presence or absence of coronary artery lesions.
- To assess the persistence of myocardial changes over time.
Main Methods:
- Evaluation of right endomyocardial biopsy specimens from 36 children (20 boys, 16 girls) diagnosed with Kawasaki Disease.
- Histopathological analysis focusing on myocellular hypertrophy, degeneration, interstitial fibrosis, and endomyocardial changes.
- Comparison of findings between patients with and without coronary artery lesions (CAL).
Main Results:
- Patients with KD and CAL exhibited significant myocellular hypertrophy (44%), degeneration (61%), interstitial fibrosis (44%), and endomyocardial changes (22%).
- Patients with KD without CAL showed myocellular hypertrophy (44%), degeneration (50%), disarray (28%), and interstitial fibrosis (6%).
- Myocardial changes including hypertrophy, disarray, and fibrosis persisted for over three years in long-standing KD cases.
Conclusions:
- Kawasaki Disease induces diverse myocardial histopathological changes.
- These changes can persist long-term, irrespective of coronary artery lesion development.
- A subset of patients with Kawasaki Disease may be at risk for developing cardiomyopathy.
Abstract:
To study the histopathology of the myocardium in Kawasaki Disease (KD) with various coronary angiographic findings, right endomyocardial biopsy specimens were evaluated on 20 boys and 16 girls with this disorder. KD with coronary artery lesions (CAL) showed various histopathological abnormalities, such as myocellular hypertrophy in 44%, degeneration in 61%, interstitial fibrosis in 44% and endomyocardial changes in 22%. KD without CAL revealed myocellular hypertrophy in 44%, degeneration in 50%, disarray in 28% and interstitial fibrosis in 6%. As in patients with long-standing KD, more than three years after onset, myocardial changes such as myocellular hypertrophy, disarray and interstitial fibrosis persisted, it is suggested that cardiomyopathy may develop in some patients with KD.