Atopic Predilection among Kawasaki Patients – A Cross-Sectional Study among 1,187,757 Teenagers

Background: Kawasaki disease (KD) is an acute systemic vasculitis disease in children with potentially serious effects on the heart but with a non-completely understood etiology. It is assumed that the development of KD is mediated by an immunologic response. Several reports from East-Asia found higher prevalence of atopic diseases among patients with KD, yet a large-data study regarding this correlation is still lacking. The purpose of this article was to achieve this goal.

Methods: We conducted a cross sectional large-data study to estimate the correlation of KD and allergic diseases. The medical history of 1,187,757 Israeli teenagers (age 16-20 during the years 1998-2013) was retrieved. The study population was divided into 3 groups according to past history of non-complicated KD, complicated KD and controls, and the prevalence of allergic diseases among these groups was further investigated.

Results: The prevalence of Atopic diseases, including Asthma, Angioedema and Allergic Rhinitis, among the 3 study groups was presented (Asthma: 11.4%, 8.1%, 3.5%. Angioedema: 7.1%, 0%, 0.46%. Allergic Rhinitis: 20%, 12.1%, 6.7%. in the complicated KD, not complicated KD, and general population groups respectively).

In non-complicated KD, statistically significant link of Asthma (OR-2.4, p =0.048) and a borderline significant link of Allergic Rhinitis (OR-1.9, p=0.06) were found. In complicated KD with cardiac complications, statistically significant links were found for all the allergic conditions (Asthma: OR-3.5, p=0.003), Allergic Rhinitis (OR-3.5, P<0.001) and Angioedema (OR-16.48, p<0.001).

Conclusion: KD is associated with allergic diseases. This association is increased with the severity of the disease. This means there is a link between cardiac manifestations and allergic diseases.