The intercostal artery in Kawasaki disease. A pathologic study of 17 autopsy cases

Two hundred twenty-seven arteries from 17 autopsy patients having a history of Kawasaki disease were studied histopathologically and immunohistologically. Forty-five arteries in four cases (duration of illness ranging from 23 to 33 days) showed an arterial lesion characterized by reactive proliferative change of the medial smooth-muscle cells and frequent aneurysmal dilation. The lesion was mostly localized to the proximal portion. The intercostal arterial lesions were similar to those in the coronary arteries except for some delay in their occurrence. It is suggested that the proliferation of medial smooth-muscle cells after their degeneration is a key feature of the arterial lesion in Kawasaki disease.