Autopsy and Case Reports
Autopsy and Case Reports
Autopsy Case Report

Oblivion: autopsy findings of a 31-year-old man with sudden cardiac arrest, a case report of a sequalae of Kawasaki disease

Daniel Fernando Gallego; Maria Eugenia Zuluaga Ruiz; Desiree Ann Marshall

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A 31-year-old man presented to the hospital after suffering a sudden cardiac arrest. Despite optimal therapy, the patient passed away. His medical history included febrile rash at age 2. At autopsy, there was aneurysmal dilation and severe coronary artery stenosis by atherosclerotic plaques and myocardial fibrosis. These findings were presumed to be due to complications of Kawasaki disease, given the remote history of severe febrile rash as a toddler and the presence of chronic coronary artery injury, recanalization, and thrombosis with ischemic heart disease leading to sudden cardiac collapse and death.


Coronary Aneurysm, Death, Sudden, Mucocutaneous Lymph Node Syndrome, Forensic Pathology, Coronary Disease


1 Gorelik M, Chung SA, Ardalan K, et al. 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Kawasaki Disease. Arthritis Care Res (Hoboken). 2022;74(4):538-48. PMid:35257507.

2 Orenstein JM, Shulman ST, Fox LM, et al. Three linked vasculopathic processes characterize Kawasaki disease: a light and transmission electron microscopic study. PLoS One. 2012;7(6):e38998. PMid:22723916.

3 Rowley AH, Baker SC, Shulman ST, et al. Cytoplasmic inclusion bodies are detected by synthetic antibody in ciliated bronchial epithelium during acute Kawasaki disease. J Infect Dis. 2005;192(10):1757-66. PMid:16235174.

4 Rowley AH, Baker SC, Orenstein JM, Shulman ST. Searching for the cause of Kawasaki disease: cytoplasmic inclusion bodies provide new insight. Nat Rev Microbiol. 2008;6(5):394-401. PMid:18364728.

5 Molina DK, Dimaio VJM. Normal organ weights in men: part I-the heart. Am J Forensic Med Pathol. 2012;33(4):362-7. PMid:22182983.

6 Molina DK, DiMaio VJM. Normal organ weights in men: part II—the brain, lungs, liver, spleen, and kidneys. Am J Forensic Med Pathol. 2012;33(4):368-72. PMid:22182984.

7 Kim DS. Kawasaki disease. Yonsei Med J. 2006;47(6):759-72.

8 Swaye PS, Fisher LD, Litwin P, et al. Aneurysmal coronary artery disease. Circulation. 1983;67(1):134-8. PMid:6847792.

9 Díaz-Zamudio M, Bacilio-Pérez U, Herrera-Zarza MC, et al. Coronary artery aneurysms and ectasia: role of coronary CT angiography. Radiographics. 2009;29(7):1939-54. PMid:19926755.

10 Sheikh AS, Hailan A, Kinnaird T, Choudhury A, Smith D. Coronary artery aneurysm: evaluation, prognosis, and proposed treatment strategies. Heart Views. 2019;20(3):101-8. PMid:31620255.

11 Naoe S, Takahashi K, Masuda H, Tanaka N. Kawasaki disease with particular emphasis on arterial lesions. Acta Pathol Jpn. 1991;41(11):785-97. PMid:1785339.

12 Takahashi K, Oharaseki T, Yokouchi Y, Naoe S, Saji T. Kawasaki disease: basic and pathological findings. Clin Exp Nephrol. 2013;17(5):690-3. PMid:23188196.

13 Rozo JC, Jefferies JL, Eidem BW, Cook PJ. Kawasaki disease in the adult: a case report and review of the literature. Tex Heart Inst J. 2004;31(2):160-4. PMid:15212128.

14 Newburger JW, Takahashi M, Burns JC, et al. The treatment of Kawasaki syndrome with intravenous gamma globulin. N Engl J Med. 1986;315(6):341-7. PMid:2426590.

15 Gordon JB, Kahn AM, Burns JC. When children with Kawasaki disease grow up: myocardial and vascular complications in adulthood. J Am Coll Cardiol. 2009;54(21):1911-20. PMid:19909870.

16 Konopka A, Chodkowska E, Piotrowski W, Stepińska J. Is the assessment of lipid profile performed up to seventy two hours from hospital admission due to acute coronary syndrome still valid? Kardiol Pol. 2004;61(9):243-50, discussion 251-2. PMid:15531936.

17 Mostafavi SN, Barzegar E, Manssori NS, Kelishadi R. First report on the lipid profile late after Kawasaki disease in Iranian children. Int J Prev Med. 2014;5(7):820-4. PMid:25104992.

18 Chen S, Lee Y, Crother TR, et al. Marked acceleration of atherosclerosis after Lactobacillus casei-induced coronary arteritis in a mouse model of Kawasaki disease. Arterioscler Thromb Vasc Biol. 2012;32(8):e60-71. PMid:22628430.

19 Newburger JW, Burns JC, Beiser AS, Loscalzo J. Altered lipid profile after Kawasaki syndrome. Circulation. 1991;84(2):625-31. PMid:1860206.

20 Zeng YY, Zhang M, Ko S, Chen F. An update on cardiovascular risk factors after Kawasaki disease. Front Cardiovasc Med. 2021;8:671198. PMid:33937365.

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