. . . and a disease seeking its raison d'etre
Since it was first reported in a Japanese journal in 1967, a relatively rare childhood disorder called Kawasaki syndrome has stubbornly rebuffed scientists' efforts to understand it. Recently completed studies indicate that the disease's incidence may be increasing in the United States and that it may be caused by a virus from the same group as that causing AIDS. But the lack of consensus among scientists on these and other aspects of the disease shows that Kawasaki syndrome still retains its secrets.
Characterized by fever, rash and occasional damage to coronary arteries, Kawasaki syndrome is thought to be an infectious disease--given its cyclic epidemics that vary with the seasons (SN: 7/6/85, p.10). Researchers have studied a series of possible disease agents, including house dust mites scattered in the air during the shampooing of rugs. But no cause has been unequivocally identified.
At last week's Interscience Conference on Antimicrobial Agents and Chemotherapy in New York City, Jane Burns of Children's Hospital in Boston called Kawasaki syndrome "a disease in search of a virus.'
Burns says her "very preliminary' studies suggest that a virus producing the enzyme reverse transcriptase may be responsible. About 70 percent of 33 Kawasaki patients tested showed an elevated level of enzyme activity typical of reverse transcriptase. Viruses making this enzyme are broadly classified as retroviruses, a group that includes the AIDS virus.
But Marian Melish of the University of Hawaii in Honolulu says that the enzyme activity seen by Burns "probably came from the patients' cells' and that her own studies do not support a human retrovirus as the cause. Melish, who was one of the first to describe Kawasaki syndrome in the United States, also reports that the incidence of the disease in Hawaii has stabilized in the past few years, yet continues to affect primarily those of Asian ancestry.
Some scientists think Kawasaki syndrome is becoming more common in the rest of the United States, where clinicians are trying to measure its possible long-term effects. Although the fever and skin rash of Kawasaki syndrome disappear and most patients recover, there are structural changes in the blood vessels of the heart in about 20 percent of patients--most of whom are less than 5 years old.
"Kawasaki syndrome is now considered the leading cause of acquired heart disease in [U.S.] children,' Stan Shulman of Children's Memorial Hospital in Chicago said at last week's meeting. "We believe the incidence has clearly increased since 1983.' He estimates that 2,000 to 2,500 U.S. cases now occur during an average year. Underreporting of the disease by physicians, however, makes exact numbers impossible to determine, he says.
COPYRIGHT 1987 Science Service, Inc.
COPYRIGHT 2004 Gale Group
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