Gene Polymorphism of Aspirin-induced Urticaria in Children with Kawasaki Disease

Backgroud: Kawasaki disease is a febrile and eruptive disease predominantly occurring in children under 5 years of age. Coronary artery complications are the most common cause of acquired heart disease in children. At present, the guidelines for the treatment of Kawasaki disease in the United States, Japan and China all indicate that high-dose aspirin should be taken in the acute stage and low-dose aspirin should be taken in the convalescent stage. The treatment of children with Kawasaki disease by aspirin has become the routine and preferred approach.However, clinically, aspirin-induced urticaria can occur in children with Kawasaki disease during aspirin administration. In severe cases, drug hypersensitivity syndrome can be induced, which endangers the life of the patient and affects the clinical application.

Objective: To investigate the distribution of the leukotriene synthase (LTC4S) A-444C gene polymorphism in children with Kawasaki disease in northern China and determine whether LTC4S A–444C is associated with AIU. Methods: The clinical data of children with Kawasaki disease who were hospitalized in the Department of Cardiology, Children`s Hospital Affiliated with the Capital Institute of Pediatrics from April 2015 to November 2017 were collected, and the LTC4S A-444C gene polymorphism was detected to analyze the relationship between the LTC4S A-444C gene polymorphism and AIU.

Results: A total of 574 children with Kawasaki disease were enrolled in the study. 1) The frequency of the A allele was 980 (85.4%), and the frequency of the C allele was 168 (14.6%). 2) Of the 417 patients with the AA genotype, 25 had urticaria, resulting in a positive rate of 6%. Of the 146 patients with the AC genotype, 11 had urticaria, resulting in a positive rate of 7.5%. Eleven patients had the CC genotype, 2 of which had urticaria, resulting in a positive rate of 18.2%. There was no significant difference among the three groups (P > 0.05).

Conclusion: LTC4S A-444C gene polymorphism exists in children with Kawasaki disease in northern China, but there is no correlation between LTC4S A-444C gene polymorphism and AIU.