Cardiovascular pathology in Kawasaki disease

Coronary artery aneurysms (CAAs) in early childhood (which can lead to myocardial infarction) can develop as a complication from a pediatric vasculitis called Kawasaki disease (KD). The exact etiology of KD is unknown, however, genetic predisposition and a triggering agent – believed to be of microbial origin – are highly suspected to play a role. This thesis contains a large cohort study from the Netherlands, combined with new insights from the SARS-CoV-2 pandemic, as the SARS-CoV-2 virus appears to be a trigger for the development of an inflammatory disease very similar, if not sometimes identical to KD. This thesis has also focused on the susceptibility for developing KD, by assessing prior pathogen exposure, potentially influencing the maturation of the immune system, also known as the “hygiene theory”. In addition, this thesis has focused on the inherent vulnerability for developing CAAs and the factors involved including gender and delayed treatment. Lastly, this thesis includes four studies concentrating on the cardiovascular assessment, including practical recommendations for cardiovascular follow-up, based on our experience as a referral center of excellence for KD.