ETIOLOGY AND PATHOGENESIS OF KAWASAKI-DISEASE

Clinical and epidemiologic features of Kawasaki disease strongly sugge st an infectious etiology, but conventional as well as highly sophisti cated studies have failed to date to identify one or more causative ag ents. As with other vasculitides, the pathogenesis of Kawasaki disease is not clearly defined although immunopathologic mechanisms clearly a re involved. Marked alterations in T-cells, B-cells, and monocytes/mac rophages occur in acute Kawasaki disease and indicate generalized immu ne activation. In addition, coronary arterial endothelial cells are ac tivated in the acute stage of Kawasaki disease. Future efforts will be directed towards improved understanding of the interrelationships of these observed immune aberrations and to the identification of one or more infectious triggers of the disease process. (C) 1997 Elsevier Sci ence Ireland Ltd.