川崎病は今も増え続けている : 徳島県下10年間の集計

Tomisaku Kawasaki saw his first case of unusual illness in a four-year-old with high fever, bilateral nonexudative conjunctivitis, redness of the lips and oral mucosa, a rash and cervical lymphadenopathy in 1961, and published in 1967. The cause of Kawasaki Disease（KD）has not known yet. In 1963, we saw a first case in Tokushima. The incidence rates per 100,000 children younger than the age of five have been steadily increasing, involving with two big prevalence in 1982 and 1986. From 1999, we enrolled 643 patients with KD for 10 years in Tokushima Prefecture. Most cases 88% were less than 5 years old and a peak incidence in children from 0 to 2 years old. KD has been more popular in winter season（1.5 times）than in other seasons. These suggest that both genetic susceptibility and environmental factors play a role in KD. In Tokushima, coronary artery aneurysm developed in 1.1%（2.4% in all Japan）. Aneurysm persist and become occlusive, thereby increasing the risk of atherosclerosis, myocardial infarction or sudden cardiac death. In 1999, the standard treatment for acute-phase KD was a 5-days regimen of intravenous（IV） gammmaglobulin（200 mg/kg/day）, supplemented with aspirin. Now, a single infusion of IV gammaglobulin（ 2 g/kg）followed by low-dose aspirin therapy. Recent regimen is more effective, but the 11% recipients were non-responder in Tokushima（20% in all Japan）. Therefor, further research is required to know the pathogenesis and host genetics in KD.