Kawasaki disease: what is the epidemiology telling us about the etiology?
Kawasaki disease (KD) is an important and common inflammatory vasculitis of early childhood with a striking predilection for the coronary arteries. It is the predominant cause of paediatric acquired heart disease in developed countries. Despite 40 years of research, the aetiology of KD remains unknown and consequently there is no diagnostic test and treatment is non-specific and sub-optimal. The consensus is that KD is due to one or more widely distributed infectious agent(s), which evoke an abnormal immunological response in genetically susceptible individuals. The epidemiology of KD has been extensively investigated in many populations and provides much of the supporting evidence for the consensus regarding etiology. These epidemiological data are reviewed here, in the context of the etiopathogenesis. It is suggested that these data provide additional clues regarding the cause of KD and may account for some of the continuing controversies in the field.
Burgner
David
D
School of Paediatrics and Child Health, University of Western Australia, Princess Margaret Hospital for Children, GPO Box D184, Perth WA 6840, Australia. dburgner@paed.uwa.edu.au
Harnden
Anthony
A
D000393:Air Pollutants / Q000633:toxicity; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications; D002648:Child; D003141:Communicable Diseases / Q000150:complications*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D009080:Mucocutaneous Lymph Node Syndrome / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D014777:Virus Diseases / Q000150:complications
D000393:Air Pollutants; D000894:Anti-Inflammatory Agents, Non-Steroidal; D016756:Immunoglobulins, Intravenous; D001241:Aspirin