A pathological analysis of Kawasaki disease--with some suggestions of its etio-pathogenesis

As a conclusion, reviewing the pathological findings of KD and several animal models it will be clear that: 1) Kawasaki Disease is a systemic disease that attacks infants of immature immunological and angio-structural background. 2) The nature of the disease is that of "one-hit" type which attacks infants with some deranged biological conditions. The fate and grade of the disease depend merely on the grade of the hit in the first week of illness. The following is just a course of adaptation and repair of the injured sites. 3) The disease starts from the initial seroexudative inflammation, and through its transient granulocyte-leading stage, comes to the final (lymph) mono-histiocyte dominant interstitial inflammation, which seems to concentrate to the arterial wall. 4) The grade of granulocyte infiltration, the high potentiality of the mesenchymal cells and the growth factor derived from aggregated platelets and destroyed muscle cells seem to decide the fate of arterial lesion. 5) This is a disease which is different from a usual infection, or immune-complex induced disease. But from a pathological point of view, it "could" be caused by some "toxic substance including some virus," proliferated in the blood stream or endothelium of the infants with somewhat deranged defense mechanisms. 6) The information from two strains of mice, SL/Ni and MRL/Mp-lpr/lpr, which develop arteritis with a participation of retrovirus, will be useful to evaluate the retrovirus theory of KD.