Medicolegal Investigation of Kawasaki Disease: Three cases of sudden death by coronary artery lesions.

Korean J Leg Med. 2003 Oct;27(2):39-44. Korean.

Department of Forensic Medicine, National Institute of Scientific Investigation, Korea. tjkwon@nisi.go.kr

The Kawasaki disease(Mucocutaneous lymph node syndrome) has been reported worldwide since the first description in 1967 in Japan. Approximately 20% of the children with untreated Kawasaki disease are believed to develop coronary artery aneurysm of which 2-3% progress to coronary artery stenosis. The early mortality of Kawasaki disease is low, resulting from coronary complications, mainly aneurysmal thrombosis with myocardial infarction. The purpose of this article is to report three cases of sudden deaths who died of cardiac sequelae of Kawasaki disease. Case 1 was a 9 year old male who died of cardiac tamponade caused by ruptured left coronary artery with features of vasculitis and aneurysmal dilatation. Case 2 was a 20 year old male who had been healthy and died suddenly and unexpectedly. At autopsy, the heart showed cardiomegaly and coronary artery aneurysm with thrombus and stenosis. Case 3 was a 10 year old male who was asymptomatic. At autopsy, the heart showed coronary artery lesions including aneurysm, fibrous thickening, and calcification, and myocardial fibrosis. According to the Classification of Kawasaki disease, case 1 was considered Stage I, and cases 2 and 3 Stage IV.

Key Words : Kawasaki disease, Coronary artery