Abstract
Some 34 years ago Dr. Tomisaku Kawasaki published his landmark paper reporting 50 children from 1960-1967 with the distinctive syndrome that now carries his name. This historic report marked the beginning of the continuing effort to uncover the mysteries associated with this fascinating illness. Individual reports of fatal coronary arteritis in children, often labeled Infantile Periarteritis Nodosa, can be found in the pediatric and pathology literature in the decades prior to Kawasaki's astute recognition of the clinical features. Clinical summaries of these cases are generally recognizable now as Kawasaki Disease. Probably the earliest such case was reported by Dr. Samuel Jones Gee of St. Bartholomew's, London, in 1870, 131 years ago. At least 28 convincing pre-1967 cases can be found in the Western literature, in addition to at least 11 cases now recognized in Japan that date back at least to 1945.Much progress has been made regarding pathogenesis, diagnosis, treatment and prognosis of Kawasaki Disease over the past 34 years. The issues that must be resolved before we fully understand the disorder and its implications include the following: 1) What is the etiology of Kawasaki Disease? 2) What are the key pathogenetic mechanisms? 3) Do all patients with Kawasaki Disease have cardiac involvement and/or diffuse arterial involvement? 4) What are the long-term implications of Kawasaki Disease? 5)What is the optimal therapy for Kawasaki Disease? and 6) What is the mechanism of action of IVIG in Kawasaki Disease?In 2001, 131 years after Gee, and 34 years after Tomi Kawasaki's recognition of Kawasaki Disease as a clinical illness, we work in the era of molecular biology, molecular immunology and with knowledge of the human genome. Our challenge is to solve the riddles of Kawasaki Disease using these molecular tools and techniques, and to recruit outstanding young scientists to this effort.
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Shulman, S. Kawasaki Disease, The First 130 Years. Pediatr Res 53, 158 (2003). https://doi.org/10.1203/00006450-200301000-00027
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DOI: https://doi.org/10.1203/00006450-200301000-00027
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