Tomisaku Kawasaki, a Japanese pediatrician who first identified an inflammatory children’s disease that now bears his name and is sometimes linked to long-term heart problems, died June 5 at a Tokyo hospital. He was 95.
The Japan Kawasaki Disease Research Center announced his death but did not cite a cause.
The disease was all but unknown before Dr. Kawasaki identified 50 cases, which he observed at his pediatric practice in Tokyo in the 1960s.
The disease has reentered public consciousness during the coronavirus pandemic, because some young covid-19 patients have displayed symptoms similar to those seen in Kawasaki disease. Two studies published in recent days by the Journal of the American Medical Association have discounted any connection and suggest that the conditions related to covid-19, the disease caused by the novel coronavirus, are a distinct syndrome.
Nonetheless, Kawasaki disease remains a serious disorder and is marked by sometimes frightening symptoms, including high fevers, body rashes, bloodshot eyes and bright red lips. The tongue will turn the color of a strawberry, and the skin will often peel, starting from the fingertips and toes. The symptoms often come without warning, primarily attacking children under the age of 5.
Kawasaki first observed the disease in a young patient in 1961. Because it did not respond to penicillin or other standard treatments, he ruled out other illnesses, such as scarlet fever and juvenile rheumatoid arthritis.
“I could make no diagnosis of this unusual sickness for which I could find no reference in any medical literature,” he told the Japan Times in 2007. “Then I saw the second case, and over the next six years saw 50 more similar cases.”
He wrote a report, including his own drawings of various patients’ rashes and other symptoms, and published his research paper in a Japanese medical journal in 1967. He published an English-language version in 1974.
At first, Kawasaki called the illness “acute febrile mucocutaneous lymph node syndrome,” but his name was soon attached to the condition now universally known as Kawasaki disease.
In its most serious manifestations, it can cause death because of coronary artery aneurysms, and it is a leading cause of acquired heart disease in children. Kawasaki disease is most prevalent in children of Asian descent, perhaps because of certain genetic markers. The greatest risk is among young children, but it can occur as late as the teen years.
“Since the first survey in 1970, there have been 200,000 reported cases in Japan,” Kawasaki told Japan Times. “Three times there have been epidemics. Kawasaki disease appears in all races and on all continents. Although more than 6,000 research papers have been written about it, the cause remains unknown.”
If treated promptly, with fever-reducing drugs and intravenous gamma globulin – which contains antibodies from blood plasma – Kawasaki disease usually has few long-term effects.
According to the Centers for Disease Control and Prevention, more than 5,000 new cases are diagnosed in the United States each year. It is classified as an infectious-disease but not a contagious one; in other words, it cannot be transmitted from one child to another.
Kawasaki organized medical seminars around the world, often requiring that interpreters be present to facilitate communication between Asian and English-language researchers and doctors.
Over the years, various studies have suggested possible breakthroughs that would determine the cause of Kawasaki disease. It often seems to break out after certain climatic events and may be spread by the wind, but no firm cause has been established.
Kawasaki frequently visited the United States, where he was often greeted by parents and children who had survived the disease.
“Every time I experience such a good prognosis, it makes me very happy,” he told the Chicago Sun-Times in 2005.
Northwestern University infectious-disease expert Stanford Shulman described Kawasaki as a “rock star” to the Sun-Times. “He made a phenomenal contribution to medicine.”
Tomisaku Kawasaki was born Feb. 7, 1925, in Tokyo. He received his medical degree in 1948 from what is now Chiba University in Chiba, Japan. He spent most of his career as a practicing pediatrician at Tokyo’s Japan Red Cross Medical Center. After retiring in 1990, he established the Japan Kawasaki Disease Research Center, which he led until last year.
His wife died in 2019, but other information about survivors was not available.
When he began his research on the disease that would bear his name, Kawasaki was baffled because it did not resemble any previously known disorder. As he began to see similar cases, he kept them in a file labeled with the Japanese equivalent of “GOK.”
“GOK,” he later told English-speaking colleagues, “stood for ‘God Only Knows.’ “