Skip to main content
NCBI home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1997 Feb;50(2):161–163. doi: 10.1136/jcp.50.2.161

Kawasaki disease, Epstein-Barr virus and coronary artery aneurysms.

G A Culora 1, I E Moore 1
PMCID: PMC499744  PMID: 9155700

Abstract

AIM: To establish whether infection with Epstein-Barr virus (EBV) contributed to the development of coronary artery lesions in a six year old child with an aneurysm and stenoses of the coronary arteries and suspected Kawasaki disease. METHODS: Postmortem paraffin wax sections of the coronary artery and myocardium were examined by in situ hybridisation for expression of EBER-1 (EBV-encoded RNA-1). Positive controls consisted of an EBV positive case of Hodgkin disease and a case of posttransplantation lymphoma. RESULTS: No EBER-1 positive cells were identified in either myocardium or walls of the coronary artery. CONCLUSIONS: Although EBV has been implicated in the aetiology of Kawasaki disease and development of coronary artery lesions, this process was not confirmed in this patient. It is likely that an unusual immunological reaction to a primary EBV infection with suspected deregulation of T helper cell activity leads to severe coronary artery damage in early childhood.

Full text

PDF
161

Images in this article

162Image
on p.162
162Image
on p.162

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akagi T., Rose V., Benson L. N., Newman A., Freedom R. M. Outcome of coronary artery aneurysms after Kawasaki disease. J Pediatr. 1992 Nov;121(5 Pt 1):689–694. doi: 10.1016/s0022-3476(05)81894-3. [DOI] [PubMed] [Google Scholar]
  2. Durongpisitkul K., Gururaj V. J., Park J. M., Martin C. F. The prevention of coronary artery aneurysm in Kawasaki disease: a meta-analysis on the efficacy of aspirin and immunoglobulin treatment. Pediatrics. 1995 Dec;96(6):1057–1061. [PubMed] [Google Scholar]
  3. Hamashima Y., Kishi K., Tasaka K. Rickettsia-like bodies in infantile acute febrile mucocutaneous lymph-node syndrome. Lancet. 1973 Jul 7;2(7819):42–42. doi: 10.1016/s0140-6736(73)91975-2. [DOI] [PubMed] [Google Scholar]
  4. Hsu C. H., Chen M. R., Hwang F. Y., Kao H. A., Hung H. Y., Hsu C. H. Efficacy of plasmin-treated intravenous gamma-globulin for therapy of Kawasaki syndrome. Pediatr Infect Dis J. 1993 Jun;12(6):509–512. doi: 10.1097/00006454-199306000-00010. [DOI] [PubMed] [Google Scholar]
  5. Kegel S. M., Dorsey T. J., Rowen M., Taylor W. F. Cardiac death in mucocutaneous lymph node syndrome. Am J Cardiol. 1977 Aug;40(2):282–286. doi: 10.1016/0002-9149(77)90021-2. [DOI] [PubMed] [Google Scholar]
  6. Kikuta H., Matsumoto S., Yanase Y., Kawasaki T., Mizuno F., Osato T. Recurrence of Kawasaki disease and Epstein-Barr virus infection. J Infect Dis. 1990 Nov;162(5):1215–1215. doi: 10.1093/infdis/162.5.1215. [DOI] [PubMed] [Google Scholar]
  7. Kikuta H., Mizuno F., Osato T., Konno M., Ishikawa N., Noro S., Sakurada N. Kawasaki disease and an unusual primary infection with Epstein-Barr virus. Pediatrics. 1984 Mar;73(3):413–414. [PubMed] [Google Scholar]
  8. Kikuta H., Nakanishi M., Ishikawa N., Konno M., Matsumoto S. Detection of Epstein-Barr virus sequences in patients with Kawasaki disease by means of the polymerase chain reaction. Intervirology. 1992;33(1):1–5. doi: 10.1159/000150224. [DOI] [PubMed] [Google Scholar]
  9. Kikuta H., Sakiyama Y., Matsumoto S., Hamada I., Yazaki M., Iwaki T., Nakano M. Detection of Epstein-Barr virus DNA in cardiac and aortic tissues from chronic, active Epstein-Barr virus infection associated with Kawasaki disease-like coronary artery aneurysms. J Pediatr. 1993 Jul;123(1):90–92. doi: 10.1016/s0022-3476(05)81546-x. [DOI] [PubMed] [Google Scholar]
  10. Koren G., Lavi S., Rose V., Rowe R. Kawasaki disease: review of risk factors for coronary aneurysms. J Pediatr. 1986 Mar;108(3):388–392. doi: 10.1016/s0022-3476(86)80878-2. [DOI] [PubMed] [Google Scholar]
  11. Leung D. Y., Chu E. T., Wood N., Grady S., Meade R., Geha R. S. Immunoregulatory T cell abnormalities in mucocutaneous lymph node syndrome. J Immunol. 1983 May;130(5):2002–2004. [PubMed] [Google Scholar]
  12. Leung D. Y., Giorno R. C., Kazemi L. V., Flynn P. A., Busse J. B. Evidence for superantigen involvement in cardiovascular injury due to Kawasaki syndrome. J Immunol. 1995 Nov 15;155(10):5018–5021. [PubMed] [Google Scholar]
  13. Leung D. Y., Meissner H. C., Fulton D. R., Murray D. L., Kotzin B. L., Schlievert P. M. Toxic shock syndrome toxin-secreting Staphylococcus aureus in Kawasaki syndrome. Lancet. 1993 Dec 4;342(8884):1385–1388. doi: 10.1016/0140-6736(93)92752-f. [DOI] [PubMed] [Google Scholar]
  14. Levin M., Tizard E. J., Dillon M. J. Kawasaki disease: recent advances. Arch Dis Child. 1991 Dec;66(12):1369–1372. doi: 10.1136/adc.66.12.1369. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Melish M. E., Hicks R. M., Larson E. J. Mucocutaneous lymph node syndrome in the United States. Am J Dis Child. 1976 Jun;130(6):599–607. doi: 10.1001/archpedi.1976.02120070025006. [DOI] [PubMed] [Google Scholar]
  16. Rowley A. H., Gonzalez-Crussi F., Shulman S. T. Kawasaki syndrome. Rev Infect Dis. 1988 Jan-Feb;10(1):1–15. doi: 10.1093/clinids/10.1.1. [DOI] [PubMed] [Google Scholar]
  17. Shulman S. T., Rowley A. H. Does Kawasaki disease have a retroviral aetiology? Lancet. 1986 Sep 6;2(8506):545–546. doi: 10.1016/s0140-6736(86)90115-7. [DOI] [PubMed] [Google Scholar]
  18. Wreford F. S., Conradi S. E., Cohle S. D., Lie J. T., Dana S. E., Puri S. Sudden death caused by coronary artery aneurysms: a late complication of Kawasaki disease. J Forensic Sci. 1991 Jan;36(1):51–59. [PubMed] [Google Scholar]
  19. Yanagihara R., Todd J. K. Acute febrile mucocutaneous lymph node syndrome. Am J Dis Child. 1980 Jun;134(6):603–614. doi: 10.1001/archpedi.1980.02130180059017. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES