title: Kawasaki disease: basic and pathological findings.
abstract: Kawasaki disease (KD) is considered to be a kind of systemic vasculitis syndrome. It most frequently affects infants and young children and primarily invades medium-sized muscular arteries, including the coronary arteries. The etiology of KD is unknown, but epidemiological data suggest involvement of infectious agents, such as bacteria and viruses, in the onset of KD. In addition, host genetics underlie the disease's pathogenesis. Histologically, coronary arteritis begins 6-8 days after KD onset, and inflammation of all layers of the artery rapidly ensues. The inflammation spreads completely around the artery, resulting in severe damage to structural components. Then, the artery begins to dilate. KD arteritis is characterized by inflammation consisting of marked accumulation of monocytes/macrophages. Aberrant activation of monocytes/macrophages is thought to be involved in the formation of vascular lesions. Inflammatory-cell infiltration persists until about the 25th day of the disease, after which the inflammatory cells gradually decrease in number. Lesions in all arteries are relatively synchronous, as they evolve from acute to chronic injury. If a giant aneurysm remains or vessel recanalization occurs after thrombotic occlusion of an aneurysm, remodeling of the vascular structure, sometimes including even reocclusion, continues even in the remote stage.
authors.affiliation: Department of Pathology, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro, Tokyo, 153-8515, Japan. keitak@oha.toho-u.ac.jp.
authors.forename: Kei
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Pathology, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro, Tokyo, 153-8515, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Oharaseki
authors.affiliation: Department of Pathology, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro, Tokyo, 153-8515, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Yokouchi
authors.affiliation: Biomedical Engineering Center, Toin University of Yokohama, 2201 Tetsu-machi, Aoba, Yokohama, 225-0025, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Naoe
authors.affiliation: Department of Pediatrics, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ohta, Tokyo, 143-8541, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Saji
mesh_terms: D003323:Coronary Aneurysm / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D003331:Coronary Vessels / Q000276:immunology / Q000473:pathology*; D004108:Dilatation, Pathologic; D018450:Disease Progression; D006801:Humans; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors