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Dr Tomisaku Kawasaki described the disease that bears his name nearly 30 years
ago.1 Kawasaki disease is now the commonest cause of
acquired heart disease in children in developed countries. Its cause remains unknown, and it
presents
doctors with many difficulties in diagnosis and management. Kawasaki disease is a systemic
febrile
vasculitis predominantly affecting children aged under 5 years. The incidence in Britain is 3.4
per
100 000 children aged under 5 years2about a third
of the incidence reported in the United States and a 30th of that in Japan.3 The most important complication, coronary arteritis leading to
formation of aneurysms, occurs in 20-30% of untreated patients.3 Thrombosis within an aneurysm, myocardial infarction, and
dysrhythmias may occur in the acute phase of the illness. The case fatality rate in Britain in 1990
was 3.7%,2 which compares unfavourably with the
United States and Japan, where in some centres it is
Diagnostic criteria for Kawasaki disease
Presence of at least five of six conditions:
Exclusion of diseases with similar presentation:
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