Kawasaki disease (KD) is the most common pediatric vasculitis and the
most frequent cause of acquired heart disease in children in the U.S.
Its etiopathogenesis is unknown, although T cell, B cell and monocyte/
macrophage populations have all been implicated in the disease. The pr
ecise role played by T cells is unclear. Analysis of T-cell activation
markers in peripheral blood has demonstrated conflicting data. Study
of tissue samples, which could clarify this issue, has been limited. E
xpansion of T cells bearing V beta 2 and V beta 8 has been reported du
ring the acute phase of the disease, suggesting that exposure to a sup
erantigen may represent one of the etiologies. Other studies, however,
have not confirmed V beta expansions of T cells; in fact, indirect ev
idence that a conventional antigen may be involved has been reported i
n certain patients. Together, these various studies suggest that the c
linical entity of KD may be induced by a variety of etiologic agents.