Coronary Artery Aneurysms Develop in Weanling Rabbits with Serum Sickness But Not in Mature Rabbits

Abstract

The involvement of the cardiovascular system in rabbits with serum sickness is similar of that in Kawasaki disease, both with respect to the histologic changes of the myocardium, the valves, the coronary arteries, and the aorta and to the sequence with which they appear. Although coronary arteritis appears the same histologically, aneurysms did not occur in mature rabbits, even in case of necrosis of an arterial segment with deletion of muscle and elastic tissue. On the other hand, weanling rabbits with serum sickness had a tendency to develop aneurysms of coronary arteries, despite little cellular infiltration and reactive fibrocellular hyperplasia.

The age factor thus appears to play an important role in the development of coronary aneurysms in Kawasaki disease, irrespective of the underlying mechanism, be it a markedly increased permeability to mediators through degenerated endothelial cells, or primary degenerated muscle cells with marked thinning of the media without much inflammatory cellular reaction.

Furthermore, this study provides an insight into the long-term prognosis of transient dilatation of coronary arteries in the acute stage of Kawasaki disease.

Get full access to this article

View all access options for this article.

References

Kawasaki T. , Kosaki F. , Okawa S. , et al: A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics 54:271-276, 1974.

Onouchi Z. , Tomizawa M. , Goto M. , et al: Cardiac involvement and prognosis in acute mucocutaneous lymph node syndrome. Chest 68:297-301, 1975.

Rich AR , Gregory JE : The experimental demonstration that periarteritis nodosa is a manifestation of hypersensitivity. Bull Johns Hopkins Hosp 72:65-88, 1943.

Fujiwara H. , Hamashima Y. : Pathology of the heart in Kawasaki disease. Pediatrics 61:100-107, 1978.

Ouchterlony O. : Diffusion-in-gel-methods for immunological analysis II. Prog Allergy 6:30-154, 1962.

Tsukamoto S. , Kitamura G. : p-Nitrophenol glucuronide method, In: Practical Application of Quantitative Analysis in Biochemistry, Tokyo: Nakagawa, Inc, 1963, pp 212-214, (Japanese).

Mason W. , Jordan S. : Immune complexes and cytotoxity. In: Kawasaki Disease . New York: Alan R. Liss, Inc, 1987 , pp 219-226.

Cochrane CG : Mechanisms involved in the deposition of immune complexes in tissues . J Exp Med 134:755-758, 1971.

Yamada K. , Shirahata A. , Shinakai A. , et al: Hematological studies on acute febrile mucocutaneous lymph node syndrome with special reference to the platelet—the thrombus formation and etiology of MCLS. Acta Paediatr Jpn 81:1263-1271, 1977.

10.

Cochrane CG , Hawkins D. : Studies on the circulating immune complex. III. Factors governing the ability of circulating complexes to localize in blood vessels. J Exp Med 127:137-154, 1967.

11.

Levin M. , Holland PC , Nokes Tjc , et al: Platelet immune complex interaction in pathogenesis of Kawasaki disease and childhood polyarteritis. Br Med J 290:1456-1460, 1985.

12.

Tanaka N. , Naoe S. , Masuda H. , et al: Pathological study of sequelae of Kawasaki disease (MCLS), with special reference to the heart and coronary arterial lesions. Acta Pathol Jpn 36:1513-1527, 1986.

13.

Leung Dym , Siegel RL , Grady S. , et al: Immunoreguratory abnormalities in mucocutaneous lymph node syndrome . Clin Immunol Immunopathol 23:100-112, 1982.

14.

Leung Dym , Geha RS , Newburger J. , et al: Two monokines, interleukin 1 and tumor necrosis factor, render cultured vascular endothelial cells susceptible to lysis by antibodies circulating during Kawasaki disease. J Exp Med 164:1958-1972, 1986.

15.

Niwa Y. , Somiya K. : Enhanced neutrophilic functions in mucocutaneous lymph node syndrome, with special reference to the possible role of increased oxygen intermediate generation in the pathogenesis of coronary thromboarteritis. J Pediatr 104:56-60, 1984.