Angiogenesis, tumor necrosis factor-α and procoagulant factors in coronary artery giant aneurysm of a fatal infantile Kawasaki disease

Pucci, Angela; Martino, Silvana; Celeste, Angela; Linari, Alessandra; Tibaldi, Maria; Camosso, Elisa; Muscio, Maruska; Barattia, G; Riva, C.; Bartoloni, Giovanni

doi:10.1016/j.carpath.2007.05.003

Cited by 10 publications

(10 citation statements)

References 14 publications

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“…Within 2 years after onset, patients with KD are known to be in a hypercoagulable state. 15,16 In fact, Onouchi et al recorded occlusion or recanalization of coronary artery aneurysms at a mean of 2.5±2.3 years after KD onset without anti-thrombotic treatment and they recommended at least 5 years of the combination regimen. 6 On the other hand, in the present study 1 patient suffered from AMI at 7 years after the onset of KD, before he started warfarin treatment, and 1 patient suffered from AMI at 9 years after onset during the time that he had stopped warfarin treatment.…”

Section: Discussionmentioning

confidence: 99%

Multicenter and Retrospective Case Study of Warfarin and Aspirin Combination Therapy in Patients With Giant Coronary Aneurysms Caused by Kawasaki Disease

Suda

Kudo

Hatori

et al. 2009

Circ J

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Background: To determine the prognosis of patients with giant coronary aneurysms (GA) caused by Kawasaki disease (KD) treated with combined oral warfarin and aspirin. Methods and Results: A multicenter follow-up study of 83 patients (65 males, 18 females) with GA who had been treated for ≥3 months with warfarin. Most patients were placed on the combination therapy as soon as the GA was detected and remained on it for 6.0±5.3 years, giving a total of 482 patient-years. Target international normalized ratio of prothrombin time ranged from 1.5 to ≥2.5. During this observational period, 5 patients suffered from 8 episodes of acute myocardial infarction and 1 died. Coronary thrombus formation enforced 6 courses of intracoronary thrombolysis in 3 patients (1-4 times). Consequently, freedom of cardiac events was 92.5% at 1 year and 91% at 10 years and the linearized cardiac event rate was 2.9% patient-year. Hemorrhagic complications occurred on 8 occasions (1 subdural hematoma) in 5 patients, giving 1.7% patient-year. Conclusions:The combination of warfarin and aspirin has an acceptably high cardiac-event-free survival in patients with GA caused by KD, though it has a certain risk of hemorrhagic complications. (Circ J 2009; 73: 1319 -1323

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Section: Discussionmentioning

confidence: 99%

Multicenter and Retrospective Case Study of Warfarin and Aspirin Combination Therapy in Patients With Giant Coronary Aneurysms Caused by Kawasaki Disease

Suda

Kudo

Hatori

et al. 2009

Circ J

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“…In the first 6 months of life, KD is rare, accounting for only 1.6% of all KD cases and often presenting as IKD or AKD mimicking rather common exanthematic diseases of childhood [5,8,9,12]. Age younger than 1 year is considered a risk factor for giant aneurysms carrying a worse prognosis [2,5,6,9,10,12].…”

Section: Discussionmentioning

confidence: 99%

“…Age younger than 1 year is considered a risk factor for giant aneurysms carrying a worse prognosis [2,5,6,9,10,12]. A diagnosis of IKD or AKD must be considered for all children with unexplained fever for 5 days or longer and two or three of the principal clinical features of KD.…”

Section: Discussionmentioning

confidence: 99%

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Incomplete and Atypical Kawasaki Disease: A Clinicopathologic Paradox at High Risk of Sudden and Unexpected Infant Death

et al. 2012

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Incomplete Kawasaki disease (IKD) and atypical Kawasaki disease (AKD) represent rare conditions. Two cases of unexpected or sudden infant death are reported. The diagnosis for a 3-month-old girl was determined by echocardiography, and the child unexpectedly died despite appropriate treatment, whereas autopsy determined the diagnosis of AKD for a 4-month-old boy. In both patients, giant coronary artery aneurysms with thrombosis and vasculitis, myocarditis, and coagulative necrosis were shown at autopsy. These rare forms of IKD and AKD carry a poor prognosis and represent a paradox between the severe cardiovascular damage and the clinical presentation that mimics common and usually self-limiting exanthematic infectious disease in infancy.

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“…The basic etiologic factor of the disease is well known: decrease durability of the vessel wall with age due to the degradation of elastin fibers and the transformation of their spatial structure, which results in the vessel widening [17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Assessment of inflammatory infiltration and angiogenesis in the thrombus and the wall of abdominal aortic aneurysms on the basis of histological parameters and computed tomography angiography study

Łukasiewicz¹,

Reszeć²,

Kowalewski³

et al. 2012

Folia Histochem Cytobiol.

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Abstract:The proliferation of vessels within the aneurysm's wall and the intraluminal thrombus of abdominal aortic aneurysm (AAA) may be the main factor responsible for progression and rupture of AAA. The aim of this study was to compare the parameters of the thrombus (size, density, contrast enhancement) measured by computed tomography (CT) with histological assessment of thrombi removed during surgery. 29 patients with AAA were examined with angio-CT. Post-surgery histopathological evaluation of AAA was performed. Slides were stained with markers of B-(CD20) and T-lymphocytes (CD3), and markers of endothelial cells (CD34). Thrombi were enhanced after contrast media administration in angio-CT (p = 0.002). There was a statistically significant correlation between contrast enhancement and the presence of B lymphocytes. Intensity of endothelial cell marker expression significantly correlated with the presence of inflammatory T-and B-cells. No statistical significant correlation was found between contrast enhancement of the thrombus and markers of endothelial cells. The accumulation of inflammatory cells in the wall of AAA thrombus results in the formation of new vessels which participates to the instability of the thrombus and AAA wall. Assessment of the inflammation and neovascularization in the wall and thrombus of the AAA might be an important factor in monitoring the progression and the risk of aneurysm's rupture.

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Angiogenesis, tumor necrosis factor-α and procoagulant factors in coronary artery giant aneurysm of a fatal infantile Kawasaki disease

Cited by 10 publications

References 14 publications

Multicenter and Retrospective Case Study of Warfarin and Aspirin Combination Therapy in Patients With Giant Coronary Aneurysms Caused by Kawasaki Disease

Multicenter and Retrospective Case Study of Warfarin and Aspirin Combination Therapy in Patients With Giant Coronary Aneurysms Caused by Kawasaki Disease

Incomplete and Atypical Kawasaki Disease: A Clinicopathologic Paradox at High Risk of Sudden and Unexpected Infant Death

Assessment of inflammatory infiltration and angiogenesis in the thrombus and the wall of abdominal aortic aneurysms on the basis of histological parameters and computed tomography angiography study

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