Summary
In recent years large numbers of the so-called “mucocutaneous lymph node syndrome” or “Kawasaki's disease” have been described by Japanese workers, but instances of this disorder are only now being reported as isolated cases by European or North American physicians. The disease has, therefore, been considered to be a new entity. One of its most striking features is the development of aneurysms of the coronary arteries in infants or children, which may lead to sudden death. Aneurysms of the coronary arteries in childhood are rare, and hence it was considered relevant to report six such cases, and to examine their possible relationship to Kawasaki's disease. The pathological changes underlying the latter disorder are not well known; they are considered to be indistinguishable from infantile polyarteritis nodosa. A diagnosis of polyarteritis nodosa was also thought to be most likely to apply in the cases presented here, particularly in view of the frequency with which aneurysms of the coronary arteries have been found in this disorder. In the absence of valid pathological distinctions between Kawasaki's disease and infantile polyarteritis nodosa, the question arises whether these entities are, in fact, different, and whether Kawasaki's disease is the new entity it is assumed to be.
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References
Adelson, L.: Periarteritis nodosa in infancy. J. Pediat. 39, 346–353 (1951)
Becker, A.E.: Kawasaki disease (letter to Editor). Lancet 1976 I, 864
Benyo, R.B., Perrin, E.V.: Periarteritis nodosa in infancy. Amer. J. Dis. Child. 116, 539–544 (1968)
Bertelsen, S., Lindahl, A.: Aneurysms of the coronary arteries: Report of two cases. Acta med. scand. 175, 590–595 (1964)
Bohman, M.: Periarteritis nodosa in an infant of three months. Acta pediat. 43, 374–378 (1954)
Brown, J.S., Billmeier, G.J., Jr., Cox, F., Ibrahim, M., Stepp, W.P., Jr., Gibson, R.: Mucocutaneous lymph node syndrome in the continental United States. J. Pediat. 88, 81–82 (1976)
Cafferky, E.A., Crawford, D.W., Turner, A.F., Lau, F.U.K., Blankenhorn, D.H.: Congenital aneurysm of the coronary artery with myocardial infarction. Amer. J. med. Sci. 257, 320–327 (1969)
Chamberlain, J.L., Perry, L.W.: Infantile periarteritis nodosa with coronary and branchial aneurysms. A case diagnosed during life. J. Pediat. 78, 1039–1041 (1971)
Clarke, J.: Embolic aneurysms of the heart, buttock, and axilla. Trans. Path. Soc. Lond. 47, 24–25 (1896)
Crocker, D.W., Sobin, S., Thomas, W.C.: Aneurysms of the coronary arteries: Report of three cases in infants and review of the literature. Amer. J. Path. 33, 819–840 (1957)
Davison, P.H., McCracken, B.H., McIlveen, D.J.: Congenital coronary arteriovenous aneurysms. Brit. Heart J. 17, 569–572 (1955)
Dawson, J.E., Jr., Ellison, R.G.: Isolated aneurysm of the anterior descending coronary artery: Surgical treatment. Amer. J. Cardiol. 29, 868–871 (1972)
Editorial: Kawasaki disease. Lancet 1976 I, 675–676
Fetterman, G.H., Hashida, Y.: Mucocutaneous lymph node syndrome (MLNS): A disease widespread in Japan which demands our attention. Pediat. 54, 268–270 (1974)
Ghahramani, A., Iyengar, R., Cunha, D., Jude, J., Sommer, L.: Myocardial infarction due to congenital coronary arterial aneurysm (with successful saphenous vein bypass graft). Amer. J. Cardiol. 29, 863–867 (1972)
Götz, E.G.: Panarteritis nodosa der KoronargefÄ\e bei einem neuneinhalb Monate alten Kind. Klin. PÄdiat. 184, 288–293 (1972)
Gould, S.E., ed.: Pathology of the heart. 2nd. ed. Springfield, Illinois: C.C. Thomas 1960
Gross, L., Epstein, E.Z., Kugel, M.A.: Histology of the coronary arteries and their branches in the human heart. Amer. J. Path. 10, 253–273 (1934)
Hamashima, Y., Kishi, K., Tasaka, K.: Rickettsia-like bodies in infantile acute febrile mucocutaneous lymph node syndrome. Lancet 1973 II, 42
Harris, P.N.: Aneurysmal dilatation of cardiac coronary arteries: Review of literature and report of a case. Amer. J. Path. 13, 89–98 (1937)
Henry, M.J., Stoeckle, H.G.E., Hipps, H.C.: Periarteritis in a 4-month old infant unresponsive to Penicillinase. Amer. Heart J. 60, 817–822 (1960)
Holt, S., Jackson, P.: Ruptured coronary aneurysm and valvulitis in an infant with polyarteritis nodosa. J. Path. 117, 83–87 (1975)
John, T.J., DeBenedetti, C.D., Zee, M.L.: Mucocutaneous lymph node syndrome in Arizona. Amer. J. Dis. Child. 130, 613–614 (1976)
Kato, H., Koike, S., Yamamoto, M., Ito, Y., Yano, E.: Coronary aneurysms in infants and young children with acute febrile mucocutaneous lymph node syndrome. J. Pediat. 86, 892–898 (1975)
Kawasaki, T., Kosaki, F., Okawa, S., Shigematsu, I., Yanagawa, J.: A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediat. 54, 271–276 (1974)
Krous, H.F., Clausen, C.R., Ray, C.G.: Elevated immunoglobulin E in infantile polyarteritis nodosa. J. Pediat. 84, 841–845 (1974)
Kühner, U., Romen, W., Sandhage, K.: Isolierte Panarteritis der Coronararterien im SÄuglingsalter. Mschr. Kinderheilk. 122, 18–22 (1974)
Kussmaul, A., Maier, R.: Ueber eine bisher nicht beschriebene eigenthümliche Arterienerkrankung (Periarteritis nodosa), die mit Morbus Brighti und rapid fortschreitender allgemeiner MuskellÄhmung einhergeht. Dtsch. Arch. klin. Med. 1, 484–518 (1866)
Landing, B.H., Larson, E.J.: Apparent identity of infantile periarteritis nodosa with coronary artery involvement (IPN) and fatal mucocutaneous lymph node syndrome (MCLS): Comparison of 20 patients from North America to patients from Hawaii and Japan (abstract). 2nd Joint Meeting, Pediat. Pathol. Club and Pediat. Pathol. Soc., Toronto 25–27, Sept. (1975). (Quoted by Robinson and Adler, 1976)
Lauer, B.A., Bruhn, F.W., Todd, J.K., Todd, W.A.: Mucocutaneous lymph node syndrome in Denver. Amer. J. Dis. Child. 130, 610–612 (1976)
Liban, E., Shamir, Z., Schorr, S.: Periarteritis nodosa in a nine month old infant. Amer. J. Dis. Child. 88, 210–215 (1954)
Liddicoat, J.E., Bekassy, S.M., O'Donnell, M.J., De Bakey, M.E.: Coronary artery aneurysms in a 9-year-old child. Surgery 76, 845–847 (1974)
Lovitt, W.V., Jr., Lutz, S., Jr.: Embryological aneurysm of the myocardial vessels. Arch. Path. 57, 163–167 (1954)
Malet & Evans: Aneurysm of coronary artery, rupture; necropsy; remarks. Lancet 1887 II, 67
Melish, M.E., Hicks, P.M., Larson, E.: Mucocutaneous lymph node syndrome (MCLNS) in the United States. Pediat. Res. 8, 427 (1976)
Munro-Faure, H.: Necrotizing arteritis of the coronary vessels in infancy: Case report and review of the literature. Pediat. 23, 914–926 (1959)
Newcombe, C.P., Whitaker, W., Keates, P.G.: Coronary arterio-venous fistulae. Thorax 19, 16–21 (1964)
Packard, M., Wechsler, H.F.: Aneurysm of the coronary arteries. Arch. intern. Med. 43, 1–14 (1929)
Radford, D.J., Sondheimer, H.M., Williams, G.J., Fowler, R.S.: Mucocutaneous lymph node syndrome with coronary artery aneurysm. Amer. J. Dis. Child. 130, 596–598 (1976)
Reimold, E.W., Weinberg, A.G., Fink, C.W., Battles, N.D.: Polyarteritis in children. Amer. J. Dis. Child. 130, 534–541 (1976)
Roberts, F.B., Fetterman, G.H.: Polyarteritis nodosa in infancy. J.Pediat. 63, 519–529 (1963)
Robinson, R., Adler, R.: Mucocutaneous lymph node syndrome in California (letter to the Editor). J. Pediat. 88, 1069–1070 (1976)
Rose, E.F.: Congenital aneurysm of the coronary artery with thrombosis and death. Sth. med. J. (Bgham, Ala.) 64, 607–609 (1971)
Scott, D.H.: Aneurysm of coronary arteries. Amer. Heart J. 36, 403–421 (1948)
Seabra-Gomes, R., Somerville, J., Ross, D.N., Emanuel, R., Parker, D.J., Wong, M.: Congenital coronary artery aneurysms. Brit. Heart J. 36, 329–335 (1974)
Tanaka, N., Sekimoto, K., Naoe, S.: Kawasaki disease: Relationship with infantile periarteritis nodosa. Arch. Path. Lab. Med. 100, 81–86 (1976)
Valaes, T.: Mucocutaneous lymph node syndrome (MLNS) in Athens, Greece. Pediat. 55, 295 (1975) (letter to the Editor)
Valdivia, E., Rowe, G.G., Angevine, D.M.: Large congenital aneurysm of the right coronary artery. Arch. Path. 63, 168–171 (1957)
Weller, S.D.V., Newstead, S.M.: Aneurysm of coronary arteries in an infant. Postgrad. med. J. 38, 639–640 (1962)
Wentworth, P., Silver, M.D.: Fatal mucotaneous lymph node syndrome — in Canada? (letter to the Editor) Canad. med. Ass. J. 115, 299–305 (1976)
Wilmer, H.A.: Two cases of periarteritis nodosa occurring in the first month of life. Bull. Johns Hopk. Hosp. 77, 275–286 (1945)
Wright, J.S., McCredie, R.M., Horton, D.A., Bennett, D.J.: Giant right coronary artery aneurysm with fistula in childhood. J. thorac. cardiovasc. Surg. 61, 242–245 (1971)
Yanagisawa, M., Kobayashi, N., Matsuya, S.: Myocardial infarction due to coronary thromboarteritis, following acute febrile mucocutaneous lymph node syndrome (MLNS) in an infant. Pediat. 54, 277–281 (1974)
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Aterman, K., Dische, M.R., Franke, J. et al. Aneurysms of the coronary arteries in infants and children. Virchows Arch. A Path. Anat. and Histol. 374, 27–44 (1977). https://doi.org/10.1007/BF00430568
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DOI: https://doi.org/10.1007/BF00430568