Epidemiology and etiology of Kawasaki disease

  • Wilbert Mason
Part of the Birkhäuser Advances in Infectious Diseases book series (BAID)


Kawasaki disease was first reported in Japan in 1967 by Dr. Tomisaku Kawasaki. It has since been recognized worldwide, and in at the United States and Japan is the most important cause of acquired heart disease in children, surpassing other more recognized conditions such as rheumatic fever, endocarditis and myocarditis. It is primarily a disease of children less than 5 years of age but has been reported in older children and adults. Risk factors for the illness include Asian ancestry, male gender and certain familial predispositions. Observations such as similarity to certain exanthematous infectious diseases, temporal-geographic clustering of cases and seasonality in incidence favors an infectious etiology. Pathology and pathogenesis of the disease indicate that it is a medium-sized artery vasculitis that results from a dramatic immune activation that in most cases reversed by immune modulating agents such as intravenous immunoglobulin. Unfortunately, the etiology of the illness remains obscure, although recent studies favor a possible viral etiology.


Vascular Endothelial Growth Factor Kawasaki Disease Pediatr Infect Toxic Shock Syndrome Coronary Artery Lesion 


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  1. 1.
    Kawasaki T (1967) Pediatric acute mucocutaneous lymph node syndrome: clinical observations of 50 cases. Arerugi (Jpn J Allergy) 16: 178–222Google Scholar
  2. 2.
    Burus JC, Kushner HI, Bastian JF, Shike M, Shimizu C, Matsubara T, Turner C (2000) Kawasaki disease; a brief history. Pediatrics 106: e27CrossRefGoogle Scholar
  3. 3.
    Melish ME, Hicks RM, Larson E (1974) Mucocutaneous lymph node syndrome in the United States. Pediatr Res 8: 427ACrossRefGoogle Scholar
  4. 4.
    Landing BH, Larson EJ (1976) Are infantile periarteritis nodosa and fatal mucocutaneous lymph node syndrome the same? Pediatrics 59: 651–662Google Scholar
  5. 5.
    Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, Shulman ST, Bolger AF, Ferrieri P, Baltimore RS et al (2004) AHA Scientific Statement. Diagnosis, treatment and long-term management of Kawasaki disease. A statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young American Heart Association. Circulation 110: 2747–2771CrossRefPubMedGoogle Scholar
  6. 6.
    Yanagawa H, Nakamura Y, Yashiro M, Uehara R, Oki I, Kayaba K (2006) Incidence of Kawasaki disease in Japan: The nationwide surveys of 1999–2002. Pediatr Int 48: 356–361CrossRefPubMedGoogle Scholar
  7. 7.
    Yanagawa H, Yashiro H, Nakamura Y, Kawasaki T, Koto H (1995) The results of 12 nationwide epidemiological incidence surveys of Kawasaki disease in Japan. Arch Pediatr Adolesc Med 149: 779–783PubMedGoogle Scholar
  8. 8.
    Yanagawa H, Yashiro M, Nakamura Y, Kawasaki T, Koto H (1995) Epidemiologic pictures of Kawasaki disease in Japan from the nationwide incidence survey in 1991–1992. Pediatrics 95: 475–479PubMedGoogle Scholar
  9. 9.
    Yanagawa H, Nakamura Y, Yashiro M, Ojima T, Tinahara S, Oki I, Zhang T (1998) Results of the nationwide epidemiologic survey of Kawasaki disease in 1995 and 1996 in Japan. Pediatrics 102: e65CrossRefPubMedGoogle Scholar
  10. 10.
    Yanagawa H, Nakamura Y, Yashiro M, Oki I, Hirata S. Zhang T, Kawasaki T (2001) Incidence survey of Kawasaki disease in 1997 and 1998 in Japan. Pediatrics 107: e33CrossRefPubMedGoogle Scholar
  11. 11.
    Yanagawa H, Nakamura Y, Ojima T, Yashiro M, Tanihara S, Oki I (1999) Changes in epidemic patterns of Kawasaki disease in Japan. Pediatr Infect Dis J 18: 64–66CrossRefPubMedGoogle Scholar
  12. 12.
    Dean AG, Melish ME, Hicks R, Palumbo E (1982) An epidemic of Kawasaki disease in Hawaii. J Pediatr 100: 552–557CrossRefPubMedGoogle Scholar
  13. 13.
    Shulman ST, McAuley JB, Pachman LM, Miller ML, Ruschhaupt DG (1987) Risk of coronary artery abnormalities due to Kawasaki disease in an urban area with small Asian population. Am J Dis Child 141: 420–425PubMedGoogle Scholar
  14. 14.
    Mason WH, Kodama D, Takahashi M (2002) The epidemiology of Kawasaki in a large urban center over a 21 year period. Pediatric Academic Societies Annual Meeting, May 17–22, 2002. Abstract # 283Google Scholar
  15. 15.
    Holman RC, Curns AT, Belay ED, Steiner CA, Schonberger LB (2003) Kawasaki syndrome hospitalizations in the United States, 1997 and 2000. Pediatrics 112: 495–501CrossRefPubMedGoogle Scholar
  16. 16.
    Taubert KA (1997) Epidemiology of Kawasaki disease in the United States and worldwide. Prog Pediatr Cardiol 6: 181–185CrossRefGoogle Scholar
  17. 17.
    Steiner C, Elixhauser A, Schnaier J (2002) The healthcare cost and utilization project: an overview. Eff Clin Pract 5: 143–151PubMedGoogle Scholar
  18. 18.
    Chang RKR (2002) Epidemiologic characteristics of children hospitalized for Kawasaki disease in California. Pediatr Infect Dis J 21: 1150–1155CrossRefPubMedGoogle Scholar
  19. 19.
    Gibbons RV, Parashar VD, Holman RC, Belay ED, Maddox RA, Powell KE, Schonberger LB (2002) An evaluation of hospitalizations for Kawasaki syndrome in Georgia. Arch Pediatr Adolesc Med 156: 492–496PubMedGoogle Scholar
  20. 20.
    Belay ED, Holman RC, Clark MJ, Destefano F, Shahriari A, Davis RL, Rhodes PH, Thompson RS, Block SB, Shinefield HR et al (2000) The incidence of Kawasaki syndrome in West Coast health maintenance organizations. Pediatr Infect Dis J 19: 828–832CrossRefPubMedGoogle Scholar
  21. 21.
    Centers for Disease Control (1985) Multiple outbreaks of Kawasaki syndrome — United States. JAMA 253: 957–958CrossRefGoogle Scholar
  22. 22.
    Han RK, Sinclair B, Newman A, Silverman ED, Taylor GW, Walsh P, McCrindle BW (2000) Recognition and management of Kawasaki disease. CMAJ 162: 807–812PubMedGoogle Scholar
  23. 23.
    Du Z-D, Zhang T, Liang L, Meng X, Li T, Kawasaki T, Nakamura Y, Yanagawa H (2002) Epidemiologic picture of Kawasaki disease in Beijing from 1995 through 1999. Pediatr Infect Dis J 21: 103–107CrossRefPubMedGoogle Scholar
  24. 24.
    Ng YM, Sung RY, Fong NC, Ho MH, Cheng YW, Lee SH, Wok WC, Wong DM, Yan MC, Kwok KL, Chin WK (2005) Kawasaki Disease in Hong Kong 1994–2000. Hong Kong Med J 11: 331–335PubMedGoogle Scholar
  25. 25.
    Huang GY, Ma XJ, Huang M, Huang MR, Gui YH, Ning SB, Zhang TH, Du ZD, Yanagawa H, Kawasaki T (2006) Epidemiologic pictures of Kawasaki disease in Shanghai from 1998 through 2002. J Epidemiol 16: 9–14CrossRefPubMedGoogle Scholar
  26. 26.
    Chang LY, Chang IS, Lu CY, Chiang BL, Lee CY, Chen PJ, Wang JT, Ho HN, Chen DS, Huang LM et al (2004) Epidemiologic features of Kawasaki disease in Taiwan, 1996–2002. Pediatrics 114: 678–682CrossRefGoogle Scholar
  27. 27.
    Park YW, Han JW, Park IS, Kim CH, Yun YS, Cha SH, Ma JS, Lee SB, Chul HK, Lee HJ, Tockgo YC (2005) Epidemiologic picture of Kawasaki disease in Korea 2000–2002. Pediatr Int 47: 382–387CrossRefPubMedGoogle Scholar
  28. 28.
    Lynch M, Holman RC, Mulligan A, Belay ED, Schonberger LB (2003) Kawasaki syndrome hospitalizations in Ireland, 1996 through 2000. Pediatr Infect Dis J 22: 959–962CrossRefPubMedGoogle Scholar
  29. 29.
    Salo E, Pelkonen P, Pettay O (1986) Outbreak of Kawasaki syndrome in Finland. Acta Paediatr Scand 75: 75–80PubMedGoogle Scholar
  30. 30.
    Holman RC, Curns AT, Belay ED, Steiner CA, Effler PV, Yarita KL, Miyamura J, Forbes S, Schonberger B (2005) Kawasaki syndrome in Hawaii. Pediatr Infect Dis J 24: 429–433CrossRefPubMedGoogle Scholar
  31. 31.
    Holman RC, Belay ED, Clark MJ, Kaufman SF, Schonberger LB (1999) Kawasaki syndrome among American Indian and Alaskan native children, 1980 through 1995. Pediatr Infect Dis J 18: 451–455CrossRefPubMedGoogle Scholar
  32. 32.
    Bell DM, Brink EW, Nitzkin JL, Hall CB, Wulff H, Berkowitz ID, Feorino PM, Holman RC, Hautley CL, Meade RH et al (1981) Kawasaki syndrome: description of two outbreaks in the United States. N Engl J Med 304: 1568–1575PubMedCrossRefGoogle Scholar
  33. 33.
    Belay ED, Maddox RA, Holman RC, Curns AT, Ballah K, Schonberger LB (2006) Kawasaki syndrome and risk factors for coronary artery abnormalities. Pediatr Infect Dis J 25: 245–249CrossRefPubMedGoogle Scholar
  34. 34.
    Stockheim JA, Innocentini N, Shulman ST (2000) Kawasaki disease in older children and adolescents. J Pediatr 137: 250–252CrossRefPubMedGoogle Scholar
  35. 35.
    Pannaraj PS, Turner CL, Bastian JF, Burns JC (2004) Failure to diagnose Kawasaki disease at the extremes of the pediatric age. Pediatr Infect Dis J 23: 789–791CrossRefPubMedGoogle Scholar
  36. 36.
    Lee KY, Hong JH, Han JW, Lee JS, Lee BC, Burgner D (2006) Features of Kawasaki disease at the extremes of age. J Pediatr Child Health 42: 423–427CrossRefGoogle Scholar
  37. 37.
    Seve P, Stankovic K, Smail A, Durand DY, Marchand G, Broussolle C (2005) Adult Kawasaki disease: report of two cases and literature review. Semin Arthritis Rheum 34: 785–792CrossRefPubMedGoogle Scholar
  38. 38.
    Rauch AM (1987) Kawasaki syndrome review of new epidemiologic and laboratory developments. Pediatr Infect Dis J 6: 1016–1021PubMedGoogle Scholar
  39. 39.
    Bronstein DE, Dille AN, Austin JP, Williams CM, Palinkas LA, Burns JC (2000) Relationship of climate, ethnicity and socioeconomic class to Kawasaki disease in San Diego County, 1994 through 1998. Pediatr Infect Dis J 19: 1087–1091CrossRefPubMedGoogle Scholar
  40. 40.
    Burns JC, Cayan DR, Tong G, Bainto EY, Turner CL, Shike T, Nakamura Y, Yashiro M, Yanagawa H (2005) Seasonality and temporal clustering of Kawasaki syndrome. Epidemiology 16: 220–225CrossRefPubMedGoogle Scholar
  41. 41.
    Mason WH, Schneider T, Takahashi M (1991) The epidemiology and etiology of Kawasaki disease. Cardiol Young 1: 196–205Google Scholar
  42. 42.
    Hirata S, Nakamura Y, Yanagawa H (2001) Incidence rate of recurrent Kawasaki disease and related risk factors from the results of nationwide surveys of Kawasaki disease in Japan. Acta Pediatr 90: 40–44CrossRefGoogle Scholar
  43. 43.
    Fujita Y, Nakamura Y, Sakata K, Hara N, Kobayashi M, Yanagawa H, Kawasaki T (1989) Kawasaki disease in families. Pediatrics 84: 666–669PubMedGoogle Scholar
  44. 44.
    Uehara R, Yashuro M, Nakamur Y, Yanagawa H (2004) Clinical features of patients with Kawasaki disease whose parents had the same disease. Arch Pediatr Adolesc Med 1166–1169Google Scholar
  45. 45.
    Dergun M, Kao A, Hauger SB, Newburger JW, Burns JC (2005) Familial occurrence of Kawasaki syndrome in North America. Arch Pediatr Adolesc Med 159: 876–881CrossRefPubMedGoogle Scholar
  46. 46.
    Mason WH, Takahashi T, Schneider T (1991) Recurrence of Kawasaki disease in a large urban cohort in the United States. In: M Takahashi, K Taubert (eds): Proceedings of the 4th International Symposium on Kawasaki Disease. American Heart Association, Dallas, Texas, 21–26Google Scholar
  47. 47.
    Morens DM, Anderson LJ, Hurwitz ES (1980) National Surveillance of Kawasaki disease. Pediatrics 65: 21–25PubMedGoogle Scholar
  48. 48.
    Belay ED, Holman RC, Maddox RA, Foster DA, Schonberger LB (2003) Kawasaki syndrome hospitalizations and associated costs in the United States. Public Health Rep 118: 464–469PubMedGoogle Scholar
  49. 49.
    Treadwell TA, Maddox RA, Holman RC, Belay ED, Shahirari A, Anderson MS, Burns J, Glode MP, Hoffman RE, Schonberger LB (2002) Investigation of Kawasaki syndrome risk factors in Colorado. Pediatr Infect Dis J 21: 976–978CrossRefPubMedGoogle Scholar
  50. 50.
    Mason WH, Takahashi M (1999) Kawasaki syndrome. Clin Infect Dis 28: 169–187PubMedGoogle Scholar
  51. 51.
    Brosuis CL, Newburger JW, Burus JC, Hojnowski-Diaz P, Zierler S, Leung DY (1988) Increased prevalence of atopic dermatitis in Kawasaki disease. Pediatr Infect Dis J 7: 863–866Google Scholar
  52. 52.
    Jennette JC, Falk RJ, Andrassy K, Bacon PA, Churg J, Gross WL, Christiaan Hagen E, Hoffman GS, Hunder GG, Cees GM et al (1994) Nomenclature of systemic vasculatides proposal of an international consensus conference. Arthritis Rheum 37: 187–192CrossRefPubMedGoogle Scholar
  53. 53.
    Fugimara H, Hamashima Y (1978) Pathology of the heart in Kawasaki disease. Pediatrics 61: 100–107Google Scholar
  54. 54.
    Leung DYM (1990) Immunologic aspects of Kawasaki syndrome. J Rheum 17(Suppl 24): 15–18Google Scholar
  55. 55.
    Leung DYM, Siegel RL, Grady S, Krensky A, Meade R, Reinherz EL, Geha R (1982) Immunoregulatory abnormalities in mucocutaneous lymph node syndrome. Clin Immunol Immunopathol 23: 100–112CrossRefPubMedGoogle Scholar
  56. 56.
    Furukawa S, Matsubara T, Motohashi T, Nakachi S, Sasai K, Yabuta K (1990) Expressions of Fc epsilon R2/CD23 on peripheral blood macrophages/monocytes in Kawasaki disease. Clin Immunol Immunopathol 56: 280–286CrossRefPubMedGoogle Scholar
  57. 57.
    Furukawa S, Matsubara T, Jujoh K, Yove K, Sagawara T, Sasai K, Kato H, Yabuto K (1988) Peripheral blood monocyte/macrophages and serum tumor necrosis factor in Kawasaki disease. Clin Immunol Immunopathol 48: 247–251CrossRefPubMedGoogle Scholar
  58. 58.
    Lang BA, Silverman ED, Laxer RM, Lau AS (1989) Spontaneous tumor necrosis factor production in Kawasaki disease. J Pediatr 115: 939–943CrossRefPubMedGoogle Scholar
  59. 59.
    Maurg CPJ, Salo E, Pelkonen P (1988) Circulating interleukin-1 in patients with Kawasaki disease. N Engl J Med 319: 1670–1671CrossRefGoogle Scholar
  60. 60.
    Rowley AH Shulman ST, Preble OT, Poiesz BJ, Erlich GD, Sullivan JR (1988) Serum interferon concentrations and retroviral serology in Kawasaki syndrome. Pediatr Infect Dis J 7: 663–667PubMedCrossRefGoogle Scholar
  61. 61.
    Ueno Y, Tokano N, Kanegane H, Yokoi T, Yachie A, Miyawaki T, Tauiguchi N (1989) The acute phase nature of interleukin-6: studies in Kawasaki disease and other febrile illnesses. Clin Exp Immunol 76: 337–342PubMedGoogle Scholar
  62. 62.
    Leung DYM, Collins T, Lapierre LA, Geha R, Pober J (1986) Immunoglobulin M antibodies present in the acute phase of Kawasaki serum lyse cultured vascular endothelial cells stimulated by gamma interferon. J Clin Invest 77: 1428–1435PubMedGoogle Scholar
  63. 63.
    Brown TJ, Crawford SE, Cornwall ML, Garcia F, Shulman ST, Rowley AH (2001) CD8 T-lymphocytes and macrophages infiltrate coronary artery aneurysms in acute Kawasaki disease. J Infect Dis 184: 940–943CrossRefPubMedGoogle Scholar
  64. 64.
    Leung DYM, Burns JC, Newburger JW, Geba RS (1987) Reversal of lymphocyte activation in vivo in the Kawasaki syndrome by intravenous gamma globulin. J Clin Invest 79: 468–472PubMedCrossRefGoogle Scholar
  65. 65.
    Avcin T, Tse SML, Schneider R, Ngan B, Silverman ED (2006) Macrophage activating syndrome as the presenting manifestation of rheumatic diseases in childhood. J Pediatr 148: 683–686CrossRefPubMedGoogle Scholar
  66. 66.
    Furuno K, Yage T, Kusuhara K, Takada H, Nishio H, Khajoce V, Ohno T, Hara T (2004) CD25+ regulatory T-cells in patients with Kawasaki disease. J Pediatr 145: 385–390CrossRefPubMedGoogle Scholar
  67. 67.
    Wang CL, Wu YT, Liu CA, Liu MW, Lee CJ, Huang LT, Yang KD (2003) Expression of CD40 ligand on CD4 T-cells and platelets correlated to the coronary artery lesion and disease progress in Kawasaki disease. Pediatrics 111: e140–147CrossRefPubMedGoogle Scholar
  68. 68.
    Thornton S (2006) Contribution of angiogenic genes to the complex genetic train underlying Kawasaki disease. Arthritis Rheum 54: 1361–1365CrossRefPubMedGoogle Scholar
  69. 69.
    Terai M, Yasukawa K, Marumoto S, Tateno S, Oaua S, Kohno Y (1999) Vascular endothelial growth factor in acute Kawasaki disease. Am J Cardiol 83: 337–339CrossRefPubMedGoogle Scholar
  70. 70.
    Maeno N, Takei S, Masuda K, Akaike H, Matsuo K, Kitajima I, Maruyama I, Miyata K (1998) Increased serum levels of vascular endothelial growth factor in Kawasaki disease. Pediatr Res 44: 596–599CrossRefPubMedGoogle Scholar
  71. 71.
    Ohno T, Igaroshi H, Inoue K, Akazawa K, Joho K, Hara T (2000) Serum vascular growth factor: a new predictive indicator for occurrence of coronary artery lesions in Kawasaki disease. Eur J Pediatr 159: 424–429CrossRefPubMedGoogle Scholar
  72. 72.
    Gavin PJ, Crawford SE, Shulman ST, Garcia FL, Rowley AH (2003) Systemic arterial expression of matrix metalloproteinases 2 and 9 in acute Kawasaki disease. Arterioscler Thromb Vasc Biol 23: 576–581CrossRefPubMedGoogle Scholar
  73. 73.
    Freeman AF, Crawford SE, Cornwall ML, Garcia FL, Shulman ST, Rowley AH (2005) Augiogenesis in fatal Kawasaki disease coronary artery and myocardium. Pediatr Cardiol 26: 578–584CrossRefPubMedGoogle Scholar
  74. 74.
    Matsuda I, Hattori S, Magata N, Fruse A, Mambu H, Itakura K, Wakisaka A (1977) HLA antigens in mucocutaneous lymph node syndrome. Am J Dis Child 131: 1417–1418PubMedGoogle Scholar
  75. 75.
    Kato S, Kimura M, Tsuji K, Kusakawa S, Asar T, Juji T, Kawasaki T (1978) HLA antigens in Kawasaki disease. Pediatrics 61: 252–255PubMedGoogle Scholar
  76. 76.
    Krensky AM, Berenberg W, Shanley K, Yanis EJ (1981) HLA antigens in mucocutaneous lymph node syndrome in New England. Pediatrics 67: 741–743PubMedGoogle Scholar
  77. 77.
    Keren G, Davon YL, Orgal S, Kolt R, Gazit E (1982) HLA Bw 51 is increased in mucocutaneous lymph node syndrome. Tissue Antigens 20: 144–146PubMedCrossRefGoogle Scholar
  78. 78.
    Krensky AM, Grady S, Shanley KM, Berenberg W, Yanis EJ (1983) Epidemic and endemic HLA-B and DR association in mucocutaneous lymph node syndrome. Hum Immunol 6: 75–77CrossRefPubMedGoogle Scholar
  79. 79.
    Kamizono S, Yamada A, Higuchi T, Kato H, Itoh K (1999) Analysis of tumor necrosis factor-α production and polymorphisms of the tumor necrosis factor-α gene in individuals with a history of Kawasaki disease. Pediatr Int 41: 341–345CrossRefPubMedGoogle Scholar
  80. 80.
    Jibiki T, Terai M, Shima M, Ogawa A, Hawada H, Kanegawa M, Yamamoto S, Kohno Y (2001) Monocyte chemoattractant 1 gene regulatory region polymorphism and serum level of monocyte chemoattractant protein 1 in Japanese patients with Kawasaki disease. Arthritis Rheum 44: 2211–2212CrossRefPubMedGoogle Scholar
  81. 81.
    Quasney MW, Bronstein DE, Cantor RM, Zhang Q, Stroupe C, Shike H, Bastian JF, Matsubara T, Fugimara M, Akimoto K et al (2001) Increased frequency of alleles associated with tumor necrosis factor-α levels in children with Kawasaki disease. Pediatr Res 49: 686–690CrossRefPubMedGoogle Scholar
  82. 82.
    Ouchi K, Suzuki Y, Shirakawa T, Kishi F (2003) Polymorphism of SLC 11A1 (Formerly NRAMP1) gene confers susceptibility to Kawasaki disease. J Infect Dis 187: 326–329CrossRefPubMedGoogle Scholar
  83. 83.
    Wu SF, Chang JS, Wan L, Tsai CH, Tsai FJ (2005) Association of IL-1Ra gene polymorphism, but no association of IL-1β and IL-4 gene polymorphisms with Kawasaki disease. J Clin Lab Anal 19: 99–102CrossRefPubMedGoogle Scholar
  84. 84.
    Shim YH, Kim HS, Sohn S, Hong YM (2006) Insertion/deletion polymorphism of angiotensin converting enzyme gene in Kawasaki disease. J Korean Med Sci 21: 208–211PubMedCrossRefGoogle Scholar
  85. 85.
    Brennis WB, Biezeveld MH, Geissler J, Ottenkamp, Kupers IM, Lam J, Hutchinson A, Weld R, Chanock SJ, Juijpers TW (2006) Vascular endothelial growth factor gene haplotypes in Kawasaki disease. Arthritis Rheum 54: 1588–1594CrossRefGoogle Scholar
  86. 86.
    Takeuchi K, Yamamoto K, Kataoka S, Takihara T, Tamaka A, Soto S, Nichiyama M (1997) High incidence of angiotensin 1 converting enzyme genotype II in Kawasaki disease patients with coronary aneurysm. Eur J Pediatr 156: 266–268CrossRefPubMedGoogle Scholar
  87. 87.
    Huang FY, Lee YJ, Chen MR, Hsu CH, Lin SP, Sung TC, Chang SC, Chang JG (2000) Polymorphism of transmembrane region of MICA gene and Kawasaki disease. Exp Clin Immunogen 17: 130–137CrossRefGoogle Scholar
  88. 88.
    Tsukahara H, Hiraoka M, Saito M, Mishida K, Kobata, Tsuchida S, Tayooka M, Kimura H, Gejyo F, Myumi M (2000) Methylenetetrahydrofolate reductase polymorphism in Kawasaki disease. Pediatr Int 42: 236–240CrossRefPubMedGoogle Scholar
  89. 89.
    Mishimura S, Faitsu M, Megumi H, Yokata G, Watanabe M, Ueda Y, Imayoshi M, Ishii E, Tasaki H, Hamasaki Y (2003) A polymorphism in the promotor or the CD14 gene (CS14/-159) is associated with the development of coronary artery lesions in patients with Kawasaki disease. J Pediatr 143: 357–362CrossRefGoogle Scholar
  90. 90.
    Onouchi Y, Onoue S, Tamari M, Makui K, Fukushima Y, Yashiro M, Nakamura Y, Yanagawa H, Kishi F, Ouchi K et al (2004) CD40 ligand gene and Kawasaki disease. J Hum Genet 12: 1062–1068CrossRefGoogle Scholar
  91. 91.
    Kariazono H, Ohno T, Khajoee V, Ibara E, Kusuhara K, Kiirukawa N, Mizuna Y, Hora T (2004) Association of vascular endothelial growth factor (VEGF) and VEGF receptor gene polymorphisms with coronary artery lesions of Kawasaki disease. Pediatr Res 56: 953–959CrossRefGoogle Scholar
  92. 92.
    Park JA, Shin KS, Kim YW (2005) Polymorphism of matrix metalloprotemase-3 promotor gene as a risk factor for coronary artery lesions in Kawasaki disease. J Med Korean Ac 20: 607–660Google Scholar
  93. 93.
    Taniuchi S, Masuda M, Teraguchi M, Ikemoto Y, Kamiyama Y, Takahashi H, Kwo M, Koboyashi Y (2005) Polymorphism of Fcγ RIIa may affect the efficacy of gamma-globulin therapy in Kawasaki disease. J Clin Immunol 25: 309–313CrossRefPubMedGoogle Scholar
  94. 94.
    Biezeveld MH, Geissler J, Wenerling GJ, Kuipers IM, Lam J, Ottenkamp J, Kuipers IM (2006) Polymorphisms in the mannose-bending lectin gene as determinants of age-defined risk or coronary artery lesions in Kawasaki disease. Arthritis Rheum 54: 369–376CrossRefPubMedGoogle Scholar
  95. 95.
    Curtis N, Zheng R, Laub JR, Levin M (1995) Evidence for a superantigen mediated process in Kawasaki disease. Arch Dis Child 72: 308–311PubMedGoogle Scholar
  96. 96.
    Abe J, Kotgin BL, Jujo K, Melish ME, Glode MP, Kohsaka T, Leung DYM (1992) Selective expansion of T-cells expressing T-cell receptor variable regions Vβ2 and Vβ8 in Kawasaki disease. Proc Natl Acad Sci USA 89: 4066–4070CrossRefPubMedGoogle Scholar
  97. 97.
    Leung DYM, Meissner HC, Fulton DR, Murray DL, Kotzin BL, Schlievert PM (1993) Toxic shock syndrome toxin secreting Staphylococcus aureus is Kawasaki syndrome. Lancet 342: 1385–1388CrossRefPubMedGoogle Scholar
  98. 98.
    Yamashiro Y, Nagata S, Oguchi S, Shimizu T (1996) Selective increase Vβ2+ T-cells in the small intestinal mucosa in Kawasaki disease. Pediatr Res 39: 364–266Google Scholar
  99. 99.
    Leung DYM, Sullivan KE, Brown-Whitearm TF, Febringer AP, Allen S, Finkel TH, Washington RL, Makida R, Schlievert PM (1997) Association of toxic shock syndrome toxin-secreting Staphylococcus aureus with Kawasaki syndrome complicated by coronary artery disease. Pediatr Res 42: 268–272CrossRefPubMedGoogle Scholar
  100. 100.
    Leung DYM, Meissner HC, Shulman ST, Mason WH, Gerber MA, Glode MP, Myones BL, Wheeler JG, Ruthazer R, Schlievert PM (2002) Prevalence of superantigen-secreting bacterial patients with Kawasaki disease. J Pediatr 140: 742–746CrossRefPubMedGoogle Scholar
  101. 101.
    Nishiyori A, Sakaguchi M, Koto H (1994) Toxic shock syndrome toxin-secreting Staphylococcus aureus in Kawasaki syndrome. Lancet 343: 299–300CrossRefPubMedGoogle Scholar
  102. 102.
    Todome Y, Ohkuni H, Mizuse M, Okibayashi F, Olitave N, Suzuki H, Long C, Igarashi H, Harada K, Sakaurai S et al (1995) Superantigenic exotoxin production by isolates of Staphylococcus aureus from the Kawasaki syndrome patients and age-matched control children. J Med Microbial 42: 91–95CrossRefGoogle Scholar
  103. 103.
    Pietra BA, Inocencio JD, Geannini EH, Hirsch R (1994) TCR Vβ family reparative and T-cell activation markers in Kawasaki disease. J Immunol 153: 1881–1888PubMedGoogle Scholar
  104. 104.
    Sakaguchi M, Kato H, Nishigori A, Sagawa K, Itoh K (1995) T-helper cells in patients with Kawasaki disease: preferential production of tumor necrosis factor-alpha (TNF alpha) by Yβ2-or Vβ8-CD4+ T-helper cells. Clin Exp Immunol 99: 276–282PubMedCrossRefGoogle Scholar
  105. 105.
    Normura Y, Yoshinaga M, Masuda K, Takei S, Miyata K (2002) Maternal antibody against toxic syndrome toxin-1 may protect infants younger than 6 months of age from developing Kawasaki syndrome. J Infect Dis 185: 1677–1680CrossRefGoogle Scholar
  106. 106.
    Nomura Y, Masuda K, Yoshinaga M, Takei S, Miyota K (2003) Possible relationship between streptococcal pyrogenic exotoxin A and Kawasaki syndrome in patients older than 6 months of age. Pediatr Infect Dis J 22: 794–798CrossRefPubMedGoogle Scholar
  107. 107.
    Matsubara K, Fukaya T, Miwa K, Shibayama N, Nigami H, Hirata T, Baba K, Suzuki T, Ishiguro A (2006) Development of serum IgM antibodies against superantigens of Staphylococcus aureus and Streptococcus pyogenes in Kawasaki disease. Clin Exp Immunol 143: 427–434CrossRefPubMedGoogle Scholar
  108. 108.
    Curtis N (2004) Kawasaki disease and toxic shock syndrome — at last the etiology is clear? Adv Exp Med Biol 549: 191–200PubMedGoogle Scholar
  109. 109.
    Rowley AH, Eckerly CA, Jack HM, Shulman ST, Baker SC (1997) IgA PC in vascular tissue of patients with Kawasaki disease. J Immunol 159: 5946–5995PubMedGoogle Scholar
  110. 110.
    Rowley AH, Shulman ST, Mask CA, Finn LS, Terai M, Baker SC, Galliani CA, Takahashi K, Mooe S, Kalelkar MB, Crawford SE (2000) IgA plasma cell infiltration of proximal respiratory tract, pancreas, kidney and coronary artery in acute Kawasaki syndrome. J Infect Dis 182: 1183–1191CrossRefPubMedGoogle Scholar
  111. 111.
    Faden H, Modlin JF, McBean AM, Ferden MB, Ogra PL (1990) Comparative evaluation of immunization with live attenuated and enhanced-potency inactivated trivalent poliovirus vaccines in childhood: systemic and local immune responses. J Infect Dis 162: 1291–1297PubMedGoogle Scholar
  112. 112.
    Rowley AH, Baker SC, Garcia FL, Guzman-Cottrill JA, Chou P, Terai M, Kawasaki T, Kalelkar MB, Crawford SE (2004) Detection of antigen in bronchial epithelium and macrophages in acute Kawasaki disease by use of synthetic antibody. J Infect Dis 190: 856–865CrossRefPubMedGoogle Scholar
  113. 113.
    Rowley AH, Shulman ST, Spike BT, Mask CA, Baker SC (2001) Oligoclonal IgA response in the vascular wall in acute Kawasaki disease. J Immunol 166: 1334–1343PubMedGoogle Scholar
  114. 114.
    Rowley AH, Baker S, Shulman ST, Fox LM, Takahashi K, Garcia FL, Crawford SE, Chou P, Orenstein JM (2005) Cytoplasmic inclusion bodies are detected by synthetic antibody in ciliated bronchial epithelium during acute Kawasaki disease. J Infect Dis 192: 1757–1766CrossRefPubMedGoogle Scholar
  115. 115.
    van der Hoek L, Pyrc K, Jibbink, MF, Vermuelin-Oost W, Berkhout KC, Wertheim-van Dillen PM, Kaandorp J, Berkhout B (2004) Identification of a new human coronavirus. Nat Med 10: 368–373CrossRefPubMedGoogle Scholar
  116. 116.
    Esper F, Weibel C, Ferguson D, Landry ML, Kahn JS (2005) Evidence of a novel human coronavirus that is associated with respiratory tract disease in infants and young children. J Infect Dis 191: 492–498CrossRefPubMedGoogle Scholar
  117. 117.
    Esper F, Shapiro ED, Weibel C, Ferguson D, Landry ML, Kahn JS (2005) Association between a novel human coronavirus and Kawasaki disease. J Infect Dis 191: 499–502CrossRefPubMedGoogle Scholar
  118. 118.
    Ebihara T, Endo R, Ma X, Ishiguro N, Kikuta H (2005) Lack of association between New Haven coronavirus and Kawasaki disease. J Infect Dis 192: 351–352CrossRefPubMedGoogle Scholar
  119. 119.
    Belay ED, Erdman DD, Anderson LJ, Peret TCT, Schrag SJ, Fields BS, Burus JC, Schonberger LB (2005) Kawasaki disease and human coronavirus. J Infect Dis 192: 352–353CrossRefPubMedGoogle Scholar
  120. 120.
    Shimizu C, Shuke H, Baker SC, Garcia F, van der Hoek L, Kuijpers TW, Reed SL, Rowley AH, Shulman ST, Talbot HKB et al (2005) Human coronavirus NL63 is not detected in the respiratory tract of children with acute Kawasaki disease. J Infect Dis 192: 1767–1771CrossRefPubMedGoogle Scholar
  121. 121.
    Chang LY, Chiang BL, Lao CL, We MH, Chen PJ, Berkhout B, Yang HC, Huang LM (2006) Lack of association between infection with a novel human coronavirus (HCoV), HCoV-NH, and Kawasaki disease in Taiwan. J Infect Dis 193: 283–286CrossRefPubMedGoogle Scholar
  122. 122.
    Kahn JS (2006) The widening scope of coronaviruses. Curr Opin Pediatr 18: 42–47PubMedGoogle Scholar
  123. 123.
    Weissbrich BM, Weske F, Schubert J, Tollmann F, Blath K, Blessing K, Kreth HW (2006) Frequent detection of bocavirus DNA in German children with respiratory tract infections. BMC Infect Dis 6: 109CrossRefPubMedGoogle Scholar

Copyright information

© Birkhäuser Verlag Basel/Switzerland 2007

Authors and Affiliations

  • Wilbert Mason
    • 1
  1. 1.Los Angeles Children’s HospitalLos AngelesUSA

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