Kawasaki disease and human bocavirus—potential association?
R.A. Santos, C.S. Nogueira, S. Granja, J.B. Baptista, M.L. Ribeiro, M.G. Rocha
Received: August 11, 2009 Revised: December 4, 2010 Accepted: December 5, 2010
E-mail address: email@example.com (C.S. Nogueira).
Background and purpose:
The cause of Kawasaki disease (KD) is unclear and there is no specific method of diagnosis; clinical suspicion is based on the identification of defined clinical criteria.1 KD is a multisystemic vasculitis of small to medium size vessels.1, 2 The natural history of KD reveals that coronary artery aneurysms occur as a sequel of the vasculitis in 20% to 25% of untreated children. Although the cause of KD remains unknown, clinical trials have established effective therapies, despite the absence of a proven cause. Intravenous immunoglobulin plus aspirin lowers the rate of coronary artery aneurysms from 20% to between 3% and 5%.3
Immunopathological mechanisms involved in the pathogenesis of KD are unclear. Although its etiology remains unknown, the clinical and epidemiological features of this disease suggest that it is infectious.1, 4 Epstein-Barr virus, adenovirus, and cytomegalovirus have all been considered as possible agents that are involved in KD.5, 6 The recently discovered human bocavirus (HBoV) is the first member of the family Parvoviridae, genus Bocavirus, to be potentially associated with human disease.7 Several studies have identified HBoV in respiratory specimens from children with acute respiratory disease but the full spectrum of clinical disease and the epidemiology of HBoV infection remain unclear.8, 9, 10 A study using nasopharyngeal aspirates from children hospitalized with fever also revealed HBoV nucleic acid in five patients hospitalized with KD.