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  • Title: [Youthful sudden cardiac death and the Kawasaki syndrome. An anatomopathological case report].
    Author: Nappo A, Rossi L, Matturri L.
    Journal: Minerva Cardioangiol; 1996 Mar; 44(3):127-32. PubMed ID: 8767612.
    Abstract:
    In 1967 Kawasaki studied 50 cases with the same features as mucocutaneous lymph node syndrome, further reported throughout Japan with the eponym of Kawasaki's disease. It is frequent in Japan and in USA, whereas in Europe it is sporadic and often misinterpreted. It presents as an acute fever, attended by irritation of the skin and oral mucosa, with swelling of cervical lymph nodes, easily misdiagnosed as scarlet fever, Stevens Johnson syndrome, or infantile exanthema or allergy. After the acute phase, Kawasaki's disease becomes chronic and sudden death is possible even if many years have elapsed. In the chronic phase, coronaritis, coronary aneurysms, marked stenosis and/or occlusive thrombosis are often present. Cardiac Lesions were classified from stage I to IV according to the duration of illness at death. The present work deals with the case of a 17 year old man, dying from undiagnosed coronary artery chronic Kawasaki disease. The patient had been hospitalized for Wolff-Parkinson-white syndrome; ten months after discharge he died suddenly, while performing gymnastics at school. Occluding thrombosis of cylindrical aneurysm of both coronary arteries, from undiagnosed Kawasaki arteritis, was found and the young boy succumbed to hyperacute infarction. The heart was fixed in buffered formalin 10% and embedded in paraffin. Histological examination of the cardiac conduction system has been carried out on serial sections, with the technique usually adopted by one of the present authors (L. Rossi). Hema-toxylin-eosin (H-E) and trichromic (Hei-denhein-azan) stainings have routinely employed.
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