Case of a 38-year-old Patient with Coronary Arterial Calcification Caused by Kawasaki Disease Evaluated with Pathological Examination and Composition Analysis

Abstract

Few studies have examined the coronary arterial calcification (CAC) caused by Kawasaki disease (KD), although it has been shown to increase the risk of acute coronary syndrome. In this study, we present the case of a 38-year-old patient with KD-induced CAC who was operated by acute myocardial infarction. Pathological examination revealed that coronary arterial lesions included atherosclerosis-like lesions and that KD-induced CAC was composed of >98% calcium phosphate with carbonate, like CAC of atherosclerosis. Radiological analysis using dual-energy computed tomography showed that the composition of KD-induced CAC resembled that of atherosclerosis. However, carotid ultrasonography and pulse wave velocity results were normal. These results suggest that KD-induced arterial calcification formed on tissues damaged in the past subsequently to arteriosclerosis. These findings suggest that patients with the past of KD, especially with KD-induced CAC, are easy to develop atherosclerosis and they should take care of the risk factors of atherosclerosis, such as hypertension, hyperlipidemia, smoking, obesity, and diabetes.