Cardiovascular pathology in 2 young adults with sudden, unexpected death due to coronary aneurysms from Kawasaki disease in childhood.

TitleCardiovascular pathology in 2 young adults with sudden, unexpected death due to coronary aneurysms from Kawasaki disease in childhood.
Publication TypeJournal Article
Year of Publication2015
AuthorsShimizu, C, Sood, A, Lau, HD, Oharaseki, T, Takahashi, K, Krous, HF, Campman, S, Burns, JC
JournalCardiovasc Pathol
Date Published2015 Feb 24
ISSN1879-1336
iDASH CategoryKawasaki Disease (DBP1 & DBP4)
Abstract<p><b>PURPOSE: </b>Coronary artery aneurysms (CAA) may remain silent after Kawasaki disease (KD) until adulthood when myocardial ischemia can lead to sudden death. We postulated that there would be young adults with sudden, unexpected death due to CAA from KD who would have a state-mandated autopsy performed by the San Diego County Medical Examiner's Office (SDCMEO).</p><p><b>METHODS: </b>We reviewed all autopsy cases <35years of age from 1997 to 2012 at the SDCMEO with a cardiovascular cause of death (n=154).</p><p><b>RESULTS: </b>We found 2 cases meeting inclusion criteria. Case 1 was a 22-year-old Korean male with chronic ischemic changes due to a partially occluded and diffusely calcified 15mm aneurysm at the bifurcation of the left main coronary artery. Interview of the mother revealed that this patient had been diagnosed with KD complicated by giant aneurysms at age two years. Case 2 was a 30-year-old Hispanic male with myocardial infarction due to thrombosis of a calcified left anterior descending artery aneurysm. Histologic findings included diffuse myocardial fibrosis and a recanalized aneurysm in the right coronary artery. Interview of the family revealed a KD-compatible illness in childhood. Immunohistochemical staining showed expression of transforming growth factor β pathway molecules in the aneurysmal arterial wall.</p><p><b>CONCLUSIONS: </b>In a medical examiner's office serving a population of approximately 3 million people, 2 of 154 (1.3%) cardiovascular deaths in persons <35years were attributed to cardiovascular complications of KD in childhood. Antecedent KD should be considered in the evaluation of all cases of sudden, unexpected death in young adults.</p>
DOI10.1016/j.carpath.2015.02.006
Alternate JournalCardiovasc. Pathol.
PubMed ID25791439
Grant ListR01 HL069413 / HL / NHLBI NIH HHS / United States
U54 HL108460 / HL / NHLBI NIH HHS / United States