KAWASAKI-DISEASE, EPSTEIN-BARR-VIRUS AND CORONARY-ARTERY ANEURYSMS

Aim--To establish whether infection with Epstein-Barr virus (EBV) cont ributed to the development of coronary artery lesions in a six year ol d child with an aneurysm and stenoses of the coronary arteries and sus pected Kawasaki disease.Methods--Postmortem paraffin wax sections of t he coronary artery and myocardium were examined by in situ hybridisati on for expression of EBER-1 (EBV-encoded RNA-1). Positive controls con sisted of an EBV positive case of Hodgkin disease and a case of posttr ansplantation lymphoma. Results--No EBER-1 positive cells were identif ied in either myocardium or walls of the coronary artery. Conclusions- -Although EBV has been implicated in the aetiology of Kawasaki disease and development of coronary artery lesions, this process was not conf irmed in this patient. It is likely that an unusual immunological reac tion to a primary EBV infection with suspected deregulation of T helpe r cell activity leads to severe coronary artery damage in early childh ood.