Tomisaku Kawasaki

Tomisaku Kawasaki
Kawasaki in 2005
Born	1 February 1925 Tokyo, Japan
Died	5 June 2020(2020-06-05) (aged 95) Tokyo, Japan
Nationality	Japanese
Education	Chiba University (MD)
Occupation	Pediatrician
Years active	1948–2019
Known for	Describing Kawasaki disease
Children	3
Medical career
Institutions	Japan Red Cross Medical Center, Hiroo
Sub-specialties	Pediatrics

Tomisaku Kawasaki (川崎 富作, Kawasaki Tomisaku, February 1, 1925 – June 5, 2020) was a Japanese pediatrician who first described the condition now known as Kawasaki disease in the 1960s.^[1][2] Alongside rheumatic heart disease, Kawasaki disease is considered to be the leading cause of acquired heart disease in children worldwide.^[3]

Tomisaku Kawasaki was born on 1 February 1925 in the Asakusa district of Tokyo, as the youngest of seven children. He was "very interested in plants and fruit, and surprised to learn how the 20th-century pear had suddenly appeared", but eventually abandoned plans to study botany because his mother favored him to be a physician. He studied medicine at Chiba University, graduating in 1948.^[4]

Kawasaki conducted his medical internship year in Chiba and decided to specialize in pediatrics, due to his fondness for children.^[5] Medical residency in post-war Japan was unpaid and as his family suffered financial problems, his advisor recommended he take up a paid position at the Japan Red Cross Medical Center in Hiroo, Tokyo. He would later practice as a pediatrician there for over 40 years.^[5]

After 10 years of researching milk allergy and unusual host-parasite cases, he saw a 4-year-old boy presenting with a myriad of clinical signs he later termed "mucocutaneous lymph node syndrome" (MCLS) in 1961.^[5][6] In 1962, he saw a second patient with the same constellation of symptoms. After he had collected a series of seven cases, he presented them at a meeting of the Japanese Pediatric Association. Reviewers rejected his submission for publication because they did not believe it was a new disease entity.^[7] Opposition from several academics over the alleged discovery of the new disease lasted several years. After he had collected a total of 50 cases, his 44-page paper was published in the Japanese Journal of Allergy in 1967.^[3][8] The paper included comprehensive hand-drawn diagrams of each patient's rashes and has been described as "one of the most beautiful examples of descriptive clinical writing".^[9] Other colleagues across the country soon reported similar cases.^[10]

In 1970, the Ministry of Health and Welfare established a research committee on MCLS headed by Dr. Fumio Kosaki.^[11] This committee conducted a nationwide study on the disease, confirming it was a new disease which specifically affected arteries across the body.^[11] In 1973, a pathologist discovered the connection to cardiac disease when he found a child with Kawasaki disease had coronary artery thrombosis at an autopsy.^[7] Kawasaki headed the Kawasaki Disease Research Committee which published its findings in the journal Pediatrics in 1974;^[12] He has been called "part Sherlock Holmes and part Charles Dickens for his sense of mystery and his vivid descriptions".^[10] It was the first time MCLS was published in English and brought international attention to the disease.^[11]

Kawasaki retired in 1990 and established the Japan Kawasaki Disease Research Center, which he led as director until 2019 and honorary chairman until 2020.^[4][9] In 1992, Kawasaki disease was officially added to Nelson's Textbook of Pediatrics, a leading textbook in the specialty, cementing international recognition of the disease.^[5]

In 2007, Kawasaki estimated over 200,000 cases of Kawasaki disease had been diagnosed in Japan since the research committee's findings in 1970.^[5] Kawasaki himself never referred to the disease by its eponymous name but conceded that the original name was too long.^[13]

Kawasaki was married to fellow pediatrician Reiko Kawasaki who died in 2019. He died on 5 June 2020 of natural causes at the age of 95 years old.^[4] He was survived by his two daughters and a son. Obituaries paying tribute to Kawasaki were published in medical journals worldwide in the aftermath of his death.^[14][15]

• Bering Kitasato Award, 1986 ^[16]
• Takeda Medical Award, 1987 ^[16]
• Health Culture Award, 1987 ^[16]
• Japan Medical Association Medical Award, 1988 ^[16]
• Asahi Prize, 1989 ^[16]
• Japan Academy Prize, 1991^[17]
• Tokyo Cultural Award, 1996
• Japan Pediatric Society Prize, 2006 ^[5]
• At some time prior to 2007, he had a personal audience with the Emperor and Empress of Japan at the Imperial Palace.^[11]
• Honored by the Tokyo Metropolitan Government

• Kawasaki T. (1967) Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Arerugi. 16 (3):178-222 (in Japanese).
• Kawasaki, T.; Kosaki, F.; Okawa, S.; Shigematsu, I.; Yanagawa, H. (1974). "A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan". Pediatrics. 54 (3): 271–276. ISSN 0031-4005. PMID 4153258.
• Kato, Shunichi; Kimura, Mikio; Tsuji, Kimiyoshi; Kusakawa, Sanji; Asai, Toshio; Juji, Takeo; Kawasaki, Tomisaku (1 February 1978). "HLA Antigens in Kawasaki Disease". Pediatrics. 61 (2): 252–255. ISSN 0031-4005. PMID 634680.
• Shigematsu, I; Shibata, S; Tamashiro, H; Kawasaki, T; Kusakawa, S (September 1979). "Kawasaki disease continues to increase in Japan". Pediatrics. 64 (3): 386. PMID 481984.
• Yanagawa, Hiroshi; Kawasaki, Tomisaku; Shigematsu, Itsuzo (1 July 1987). "Nationwide Survey on Kawasaki Disease in Japan". Pediatrics. 80 (1): 58–62. ISSN 0031-4005. PMID 3601519.
• Fujita, Yasuyuki; Nakamura, Yosikazu; Sakata, Kiyomi; Hara, Norihisa; Kobayashi, Masayo; Nagai, Masaki; Yanagawa, Hiroshi; Kawasaki, Tomisaku (1 October 1989). "Kawasaki Disease in Families". Pediatrics. 84 (4): 666–669. ISSN 0031-4005. PMID 2780128.
• Burns, Jane C.; Shike, Hiroko; Gordon, John B.; Malhotra, Alka; Schoenwetter, Melissa; Kawasaki, Tomisaku (July 1996). "Sequelae of Kawasaki disease in adolescents and young adults". Journal of the American College of Cardiology. 28 (1): 253–257. doi:10.1016/0735-1097(96)00099-X. PMID 8752822.