Cardiac biopsy in Kawasaki disease

Yutani, Chikao; Imakita, Masami; Ueda, Hatsue; Suzuki, Junko; Kamiya, Tetsuro; Onishi, Shunzo

doi:10.1007/bf02072408

Cited by 73 publications

(113 citation statements)

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“…The injured myocytes showed several microscopic findings similar to those observed in human patients [1,4,5,9,11]. In contrast, in normal hearts, several characteristics of degenerated myocytes were observed randomly in the left ventricular wall and each individual feature (as listed in Table 1) was detected independently in myocardial cells.…”

Section: Discussionsupporting

confidence: 74%

“…These myocardial cells were located randomly and sparsely in the left ventricular wall. In human myocardial infarction, eosinophilic myocytes are observed from about 6 h after the onset of infarction [4,5,11] and commonly accompany elongation of myocardial cells and/or intercellular edema [11]. Therefore, these findings in normal hearts postmortem may not be due to postmortem degeneration and we have to be prudent in using this characteristic to diagnose myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

“…The latter was carried out using Envision + kit (Dako A/S) according to the manufacturer's instructions. Histological or immunohistological changes of the left ventricular wall and papillary muscles were observed under a light microscope to detect characteristic of recent ischemic myocardial changes [1,4,5,9,11].…”

Section: Preparation Of Histological Sectionsmentioning

confidence: 99%

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Discrimination of Recent Ischemic Myocardial Changes in WHHLMI Rabbits from the Findings of Postmortem Degeneration

et al. 2005

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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Discrimination of Recent Ischemic Myocardial Changes in WHHLMI Rabbits from the Findings of Postmortem Degeneration

et al. 2005

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“…Biopsy of the right ventricular myocardium was performed in 201 patients with Kawasaki disease to assess the evolution and course of myocardial change. 136 The interval between onset of the disease and myocardial biopsy ranged from 2 months to 11 years. Myocardial abnormalities, including fibrosis and cellular disarrangement, as well as abnormal branching and hypertrophy of myocytes, were detected at all time periods after onset of the disease; their severity was unrelated to the presence of coronary artery abnormalities.…”

Section: Myocarditismentioning

confidence: 99%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease

Newburger¹,

Takahashi²,

Gerber³

et al. 2004

Circulation

1,602

818

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Background— Kawasaki disease is an acute self-limited vasculitis of childhood that is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in ∼15% to 25% of untreated children and may lead to ischemic heart disease or sudden death. Methods and Results— A multidisciplinary committee of experts was convened to revise the American Heart Association recommendations for diagnosis, treatment, and long-term management of Kawasaki disease. The writing group proposes a new algorithm to aid clinicians in deciding which children with fever for ≥5 days and ≤4 classic criteria should undergo echocardiography, receive intravenous gamma globulin (IVIG) treatment, or both for Kawasaki disease. The writing group reviews the available data regarding the initial treatment for children with acute Kawasaki disease, as well for those who have persistent or recrudescent fever despite initial therapy with IVIG, including IVIG retreatment and treatment with corticosteroids, tumor necrosis factor-α antagonists, and abciximab. Long-term management of patients with Kawasaki disease is tailored to the degree of coronary involvement; recommendations regarding antiplatelet and anticoagulant therapy, physical activity, follow-up assessment, and the appropriate diagnostic procedures to evaluate cardiac disease are classified according to risk strata. Conclusions— Recommendations for the initial evaluation, treatment in the acute phase, and long-term management of patients with Kawasaki disease are intended to assist physicians in understanding the range of acceptable approaches for caring for patients with Kawasaki disease. The ultimate decisions for case management must be made by physicians in light of the particular conditions presented by individual patients.

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“…Diffuse myocarditis followed by myocardial fibrosis may lead to systolic or diastolic dysfunction in a subset of KD patients. 27,28 Histologic evidence of myocarditis in the acute phase of Kawasaki disease is present in virtually all cases by endomyocardial biopsy 29 and in a majority of subjects when assessed by WBC-labeled radionuclide studies30. Myocarditis were found in 30% cases.…”

mentioning

confidence: 99%

Echocardiographic evaluation of complete and incomplete Kawasaki disease in terms of coronary and non coronary cardiac involvement

Sarkar¹,

Chatterjee²,

Periwal³

et al. 2017

J Coll Med Sci-Nepal

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Background & Objectives: With increasing incidence of Kawasaki disease and its associated complications, the need of the hour is early diagnosis. Incomplete Kawasaki is often diagnosed late and is frequently associated with morbidities and mortalities. Our study aims to emphasize the importance of echocardiography in detection of incomplete Kawasaki disease.Materials & Methods: A total of 150 children, clinically diagnosed as Kawasaki disease were evaluated echocardiographically and involvement of coronary artery and associated cardiac involvements were studied.Results: Amongst the incomplete Kawasaki disease patients 76% were from extremes of ages and 19.2% of them had coronary involvement. Myocarditis(38.1%) was the commonest non-coronary findings.Conclusion: Atypical Kawasaki disease is more common in extremes of ages and echocardiography helps in detecting atypical disease at the earliest, thus facilitating prompt treatment and reducing complications.

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Cardiac biopsy in Kawasaki disease

Cited by 73 publications

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Discrimination of Recent Ischemic Myocardial Changes in WHHLMI Rabbits from the Findings of Postmortem Degeneration

Discrimination of Recent Ischemic Myocardial Changes in WHHLMI Rabbits from the Findings of Postmortem Degeneration

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease

Echocardiographic evaluation of complete and incomplete Kawasaki disease in terms of coronary and non coronary cardiac involvement

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