Angiogenesis, tumor necrosis factor-alpha and procoagulant factors in coronary artery giant aneurysm of a fatal infantile Kawasaki disease.
BACKGROUND
Kawasaki disease (KD) is an infantile febrile illness of unknown origin characterized by clinical, laboratory and histopathologic features of systemic vasculitis.


RESULTS
We report a 3-month-old female infant with incomplete KD who suddenly died despite intravenous immunoglobulin, aspirin, steroid and heparin treatment. Postmortem examination confirmed the echocardiographically detected giant coronary aneurysms and showed occlusive thrombosis in the giant aneurysm of the left anterior descending coronary artery, associated with neoangiogenesis, macrophage infiltration and immunostaining for tissue factor (a strong initiator of the coagulation cascade), thrombopoietin receptor and tumour necrosis factor-alpha.


CONCLUSIONS
These findings show the association of angiogenesis, tumor necrosis factor-alpha and procoagulant factors, with macrophage infiltration in coronary artery aneurysms of a fatal infantile KD.
Pucci
Angela
A
Department of Pathology, Regina Margherita Hospital, Turin 10126, Italy. angelapucci@libero.it <angelapucci@libero.it>
Martino
Silvana
S
Celeste
Angela
A
Linari
Alessandra
A
Tibaldi
Maria
M
Camosso
Elisa
E
Muscio
Maruska
M
Barattia
Giacomo
G
Riva
Caterina
C
Bartoloni
Giovanni
G
D001779:Blood Coagulation Factors / Q000096:biosynthesis*; D003323:Coronary Aneurysm / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008264:Macrophages / Q000378:metabolism / Q000473:pathology; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000209:etiology* / Q000473:pathology; D053628:Receptors, Thrombopoietin / Q000096:biosynthesis; D013925:Thromboplastin / Q000096:biosynthesis; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis*
D001779:Blood Coagulation Factors; D053628:Receptors, Thrombopoietin; D014409:Tumor Necrosis Factor-alpha; D013925:Thromboplastin