Kawasaki Disease: A Review

Abstract

Kawasaki disease, which was first described in Japan in 1967 by Dr. Tomisaku Kawasaki, is now the leading cause of acquired heart disease in children in developed nations. Kawasaki disease is an acute, self-limited vasculitis that primarily involves the coronary arteries (Newburger et al., 2004). Although it is more prevalent in Japan and in children of Japanese ancestry than among other people, the disease occurs in communitywide epidemics in children of all races. More than 4000 cases are diagnosed in the United States each year, with a 10-fold greater incidence in Japan. In 2000, 4248 hospitalizations were associated with the disease in the United States (Fimbres & Shulman, 2008; Holman, Curns, Belay, Steiner, & Schonberger, 2003). As expected, children of Japanese ancestry predominated, with an annual incidence of 112 per 100,000 children younger than 5 years. An annual incidence of 32.5 per 100,000 children younger than 5 years was reported for Americans of Asian and Pacific Island descent, compared with 16.9 for non-Hispanic African Americans, 11.1 for Hispanic children, and 9.1 for whites (Fimbres & Shulman, 2008; Holman et al., 2003). In the United States, 76% of children who present with Kawasaki disease are younger than 5 years, with the median age of onset being about 2 years (Chang, 2003; Holman et al., 2003). The disease occurs more commonly during the winter and early spring, and it affects more boys than girls by a ratio of 1.5 to 1.7:1 (Holman et al., 2003).