KAWASAKI-DISEASE - ETIOLOGIC ISSUES NOT RELATED WITH A SUPERANTIGEN MEDIATED PROCESS

Even though Kawasaki disease was identified in 1967, its etiology rema ins unknown. Because of clinical similarities, toxic exposure to mercu ry was first suggested as an etiologic factor but has not been confirm ed. Exposure to house dust mite and/or to rug shampoo was associated w ith Kawasaki disease in a few case-control studies but contradicted in others. The clinical and epidemiologic features of the illness are hi ghly suggestive of an infectious etiology. The failure to identify a c ausative organism using conventional cultures and serological test and the failure of antibiotic treatment indicate that the disorder is pro bably not due to-any known bacterial or viral pathogen. Recent studies have failed to confirm evidence of a retroviral infection. Identifica tion of the etiologic agent is clearly essential for the development o f a specific diagnostic test and of specific therapeutic and preventiv e guidelines. The search for the etiology of Kawasaki disease continue s and superantigen toxins are now being investigated.