Dr. Anne Rowley on Kawasaki Disease

October 29, 2010 - Dr. Anne Rowley, M.D. is a Professor of Pediatrics and of Microbiology-Immunology at the Feinberg School of Medicine, Northwestern University. She is also currently an Attending Physician in the Infectious Diseases Division of Children's Memorial Hospital. Dr. Rowley is also the mother of several UND alumni.

Anne Rowley has spent over 25 years searching for the answer to questions raised by the rare condition, Kawasaki Disease (KD) on behalf of the children and families affected by this acute, potentially fatal vasculitis of young childhood. She is one of two NIH funded principal investigators in this area despite the fact that Kawasaki Disease has replaced acute rheumatic fever as the most common cause of acquired heart disease in children in the US and other developed nations. On October 29, 2010, Dr. Rowley addressed the Clinical-Translational Seminar Series audience, including the students in Professor Haldar's BIOS40450 course. Her seminar was entitled, " Synthetic Kawasaki Disease antibodies identify cytoplasmic inclusion bodies in Kawasaki Disease tissues." In preparation for her lecture, Dr. Rowley asked students to read "Searching for the cause of Kawasaki disease cytoplasmic inclusion bodies provide new insight." (Rowley A, Baker S, Orenstein J, Shulman ST. Nature Reviews Microbiology ; May 2008, Vol. 6 Issue 5, p394-401).

KD begins as an acute illness, striking previously healthy infants and children. Its signs include primarily a high spiking fever and four of the following: rash, red eyes, red lips and mouth, swollen and red hands and feet, and swollen glands in the neck. While these symptoms often abate after 1-3 weeks following treatment with intravenous gammaglobulin and aspirin, arterial inflammation throughout the body can in some rare cases, result in coronary-artery aneurysms and heart attacks. In these cases, children require treatments such as angioplasty or stent replacement, bypass surgery or transplantation. Since the onset of KD is similar to other conditions producing childhood fever, the search for KD's aetiology is critical to developing diagnostic testing that will clearly prompt appropriate treatments.

While the causes of KD remain unknown, Dr. Rowely points out the narrowing focus of research as factors are ruled in and out. It is suspected that KD has an infectious cause, but thus far studies have not identified any known agents. The pathogenesis of KD is difficult to study because coronary arterial tissue cannot be obtained from living patients and biopsy sampling of lymph nodes is ethically restricted in children. Compounding the problem, is the failure to achieve an animal model using tissue from KD patients. Recent progress owes to post-mortem tissue samples that show the role of oligoclonal IgA plasma cells in inflamed tissues and "the subsequent identification of viral-like cytoplasmic inclusion bodies in tissues inflamed by KD" (Rowley et al., 2008).

In addition to discussing Dr. Rowley's paper and the technical dimension of her laboratory's work, CRND students talked with Dr. Rowley about the clinical aspects of her work with patients. Dr. Rowley's shared the origin of her ability to pursue KD for several decades in her profound commitment to her young patients, including those memorialized in the anniversaries she observes each year.

(Photo W Wall, 2010)

 

 

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