Sudden cardiac death caused by Kawasaki coronary artery vasculitis in a child with Hodgkin's lymphoma. Case report and literature review
Cecilia Salzillo, Monica De Gaspari, Cristina Basso, Mariantonietta Francavilla, Francesco De Leonardis, Andrea Marzullo
Abstract
• KD is a vasculitis that mainly affects children under 5 years of age. • Etiopathogenesis is still not clear, but it is thought to be a complex interplay of genetic factors, infections and immunity. • Cardiac complications are rare, but thrombosis of the coronary artery may occur, causing vascular occlusion and subsequent myocardial ischemia. • Cases of association of KD with lymphoma have not been still reported. Coronary artery vasculitis is a rare pathological condition and is often a manifestation of systemic vasculitis, such as Polyarteritis Nodosa, Kawasaki Disease, Takayasu Arteritis, and Giant Cell Arteritis, with Kawasaki Disease being the most common cause in children. We present the autopsy case of a 6-year-old boy with classic Hodgkin lymphoma who died of sudden cardiac death due to thrombosis caused by vasculitis, which exclusively affected the coronary arteries and was suggestive of Kawasaki Disease. To further investigate the histological features of Kawasaki Disease across all age groups, we conducted a literature review using the search terms “Kawasaki AND vasculitis AND histopathology” and “Kawasaki vasculitis histopathology” in Scopus, Google Scholar, and PubMed, covering the period from 1967 to 2023. The inclusion criteria were as follows: coronary histology (inflammation and/or aneurysm and/or thrombosis), postmortem studies, English language, free articles, all age groups, case reports, and case series.