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Fatal Kawasaki disease with incomplete criteria: Correlation between optical coherence tomography and pathology
Author(s) -
Dionne Audrey,
Kokta Victor,
Chami Rose,
Morissette Geneviève,
Dahdah Nagib
Publication year - 2015
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12719
Subject(s) - medicine , kawasaki disease , optical coherence tomography , intimal hyperplasia , aneurysm , internal elastic lamina , cardiology , coronary arteries , thrombosis , artery , radiology , pathology , vasa vasorum , smooth muscle
Abstract Coronary artery aneurysm is a serious complication of Kawasaki disease (KD). A 3‐month‐old infant presented with severe KD 27 days after onset of fever. The patient presented with shock, inferolateral ischemia on electrocardiogram and high troponin. Echocardiography showed severe myocardial dysfunction with diffuse coronary dilation and right coronary artery aneurysm. Arterial Doppler demonstrated thrombosis of aneurysmal axillary and iliac arteries. Withdrawal of support was implemented due to multi‐organ failure. Post‐mortem optical coherence tomography correlated with pathology. The pulmonary artery was normal on OCT and histology. Coronary arteries showed aneurysmal dilatation, with intimal hyperplasia and preserved media on OCT. Pathology confirmed these findings, with destruction of the internal elastic lamina, luminal myofibroblastic proliferation, neovascularization, and partial disappearance of the media. This is the first report of pathologic correlation in KD with OCT at the subacute stage, which adequately identified structural wall changes.