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Tomisaku Kawasaki

by Vivienne Kenrick

Dr. Tomisaku Kawasaki bears the distinction of having his name attached to a little-known children’s disease. This naming was not something that he, a modest man, sought.

The first time he saw the illness was in a 4-year-old boy in 1961. “I could make no diagnosis of this unusual sickness for which I could find no reference in any medical literature,” he said.

He saw his second case a year later, and again “realized that I had seen two instances which did not exist in any medical textbook.”

With interest aroused, he applied himself to research. In 1992 in “Nelson,” the standard textbook of pediatrics in the United States, the listing of Kawasaki disease was established. Since then it has become internationally accepted.

Kawasaki, the youngest of seven children in his family, was born in 1925 in Tokyo. “I was very interested in plants and fruit, and surprised to learn how the 20th-century pear had suddenly appeared,” he said. “I wanted to continue studying mutation. My mother wanted me to become a doctor.”

After graduating from Chiba University Medical School, Kawasaki as an intern moved through different fields of medicine. He became interested in pediatrics.

“Adult patients were full of complaints, but sick children said little. Basically, I liked children,” he said. “I did my residency in Chiba immediately after World War II and the residency was without pay.

“My family was having financial difficulties, and I asked my adviser to help me find a paying position in a hospital. He helped me get an appointment in the pediatrics department at the Red Cross Hospital in Hiroo, Tokyo.” Kawasaki was to stay there for 40 years.

At first he had the benefit of working with an outstanding pediatrician. From him he learned the importance of giving full attention to each patient, and of completing detailed reports. His next chief pediatrician was academically oriented. “I had researched milk allergy and spent many hours doing blood tests in the laboratory.

When my chief read my research paper, he said that 10 percent of it was good and 90 percent was bad. That galvanized me. I was determined to be a better medical researcher,” Kawasaki said.

He decided to concentrate on unusual host-parasite cases. “I saw several, but never a second similar one, so I could not do a research paper based on just one. This continued for several years,” he said.

He had been at the Red Cross Hospital 10 years when he saw his first patient suffering from what became known as Kawasaki disease.

“I presented this case at a clinical conference in the hospital. One doctor suggested it was atypical scarlet fever, but I knew it was not. Finally the case was released as being of unknown diagnosis.

“Then I saw the second case, and over the next six years saw 50 more similar cases. I gave my report in a Japanese medical journal,” Kawasaki said. The report was entitled “Acute Febrile Mucocutaneous Lymph Node Syndrome.”

His publication led to “a huge response from doctors all over Japan, asking for reprints of my article. Some doctors made suggestions. Some in local areas reported that they had seen similar MCLS cases.”

It took time, from 1961 to 1970, before the Ministry of Health and Welfare established a research committee on MCLS. This committee carried out a nation-wide survey, which showed that MCLS was a new type of disease involving all the arteries of the body.

For two lengthy periods, Kawasaki acted as chairman of what was to become known as the Kawasaki Disease Research Committee. Kawasaki published a paper in a leading American pediatrics journal, which brought in a response on an international level.

In another 10 years, a standard treatment was established, eventually resulting in the successful care of most patients.

Kawasaki said, “Since the first survey in 1970, there have been 200,000 reported cases in Japan. 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.”

Kawasaki is retired from the directorship of the department of pediatrics at the Red Cross Hospital. For the last 17 years he has been director of the Japan Kawasaki Disease Research Center, and is guest professor at Kurume University. He lectures in America.

He has won several awards, the most recent being the first Japanese Pediatric Society Prize.

He received another signal honor when the Emperor and Empress of Japan invited him to the Imperial Palace to tell them about his pioneering work. For him, that was the culmination of his nearly 60 years of helping sick children.