Pathogenesis
exposure to an antigen or superantigen (HSP63)
acute activation of the immune system
activation of endothelial cells and monocytes
activated T and B cells infiltration
elevation of proinflammatory cytokines
vasculitis of medium (coronary) and large blood vessels
Notes:
The exact pathogeny of Kawasaki disease is still unknown even if an infectious cause is presumed. The hypothesis of superantigen role was often debated, supported by some new findings (coronaritis in some toxic shock syndrome, immunity against HSP65 and 63 in blood of Kawasaki disease patients). However, tissue lesions are due to activation of an immune cascade and mediated by a lot of inflammatory cytokines. Some current studies are more interested in determine a specific diagnosis test, with some preliminary results concerning metalloproteases.