Kawasaki disease (KD) is now the most common cause of acquired heart d
isease in children in the United States and in Japan. Despite 20 years
of research since the first English-language report of KD, the etiolo
gy of this disease continues to elude us. The long-term effects of the
acute vasculitis on the health of the coronary arteries in adulthood
is similarly unknown. A review follows of the progress that has been m
ade in our understanding of the pathogenesis and treatment of this mys
terious illness.