Which finding is NOT a typical histologic feature of Kawasaki disease affecting the coronary arteries?

Which finding is NOT a typical histologic feature of Kawasaki disease affecting the coronary arteries?

• A. Transmural vasculitis with aneurysm formation
• B. Thrombosis within the coronary arteries
• C. Endothelial swelling and edema
• D. Endocardial calcification

Answer: (D)

Kawasaki disease causes a necrotizing, transmural vasculitis of the coronary arteries, with damage spanning the wall that weakens the vessel and leads to aneurysm formation. Histology typically shows inflammatory infiltrates throughout the vessel wall, fibrinoid necrosis of the media, endothelial injury with swelling, and later proliferative changes in the intima that can promote thrombosis or luminal narrowing. Endocardial calcification is not a feature of Kawasaki’s coronary involvement; calcification of the endocardium is more typical of other conditions (such as chronic valvular disease or prior ischemic damage) and does not reflect the primary arterial wall pathology seen in this disease.

Kawasaki disease causes a necrotizing, transmural vasculitis of the coronary arteries, with damage spanning the wall that weakens the vessel and leads to aneurysm formation. Histology typically shows inflammatory infiltrates throughout the vessel wall, fibrinoid necrosis of the media, endothelial injury with swelling, and later proliferative changes in the intima that can promote thrombosis or luminal narrowing. Endocardial calcification is not a feature of Kawasaki’s coronary involvement; calcification of the endocardium is more typical of other conditions (such as chronic valvular disease or prior ischemic damage) and does not reflect the primary arterial wall pathology seen in this disease.