Incidence and short-term outcomes of Kawasaki disease

Robinson, Cal; Chanchlani, Rahul; Gayowsky, Anastasia; Brar, Sandeep; Darling, Elizabeth; Demers, Catherine; Klowak, Jennifer Ann; Knight, Braden; Kuenzig, M Ellen; Mondal, Tapas; Parekh, Rulan S.; Seow, Hsien; Jiménez-Rivera, Carolina; Webster, Richard; Fung, Stephen; Benchimol, Eric I; Batthish, Michelle

doi:10.1038/s41390-021-01496-5

Cited by 14 publications

(8 citation statements)

References 39 publications

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“…In our population, 16.1% (n = 10) of them presented with cardiac complication, mainly presenting with CAA (n = 6). This finding was higher than that of a wide-scale study done in Japan (9%) and another study in Canada (2.4%), which probably attributed to delayed diagnosis and initiation of treatment in our population (16,22,76). Various studies reported that CAA more frequently affected KD patients of younger age (28,78,78).…”

Section: Discussioncontrasting

confidence: 63%

Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment

et al. 2023

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IntroductionKawasaki disease (KD) is an acute idiopathic systemic vasculitis with a self- limiting course that predominantly affects children under 5 years old, particularly in the East Asian countries. Nevertheless, to date, the data on KD in Malaysia are limited. This study aimed to evaluate the epidemiology, clinical features, treatment, and outcomes of KD among the pediatric patients admitted to Hospital Canselor Tunku Muhriz (HCTM), Kuala Lumpur, Malaysia.MethodA retrospective cohort study of 66,500 pediatric patients presented at HCTM from the year 2004 to 2021 was conducted.Results62 KD cases out of 66,500 pediatric admissions were reported, with a male-to-female ratio of 1.58 to 1. Majority of KD patients (95.0%) were younger than 5 years old. Prior infection was reported in 5 KD patients (8.1%). Apart from the classical features, manifestations of various organ systems including cardiovascular (16.1%), gastrointestinal (43.5%), neurological (1.61%), musculoskeletal (1.61%), and genitourinary (17.7%) systems were observed. There was a significant association between sterile pyuria and coronary artery aneurysm (CAA) (p < 0.05). Interestingly, abnormal liver parameters (p < 0.05) and incomplete KD (p < 0.05) were significantly related to IVIG resistance.DiscussionThe presence of family history, immunological disorder, and previous infection in our KD patients suggested that there is a possibility of genetic, immunological, and infectious roles in the pathophysiology of KD. IVIG resistance is more likely to occur in KD patients with hepatic dysfunction or incomplete KD presentation. These findings highlighted the significant contribution of laboratory parameters to the prognosis of KD, prompting more in-depth research on the KD scoring systems and their relevance in this country.

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Section: Discussioncontrasting

confidence: 63%

Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment

et al. 2023

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“…Globally, ethnicity is the most important factor influencing the incidence of KD [ 8 – 11 ]. This is evident from the very high incidence of KD in Japan, as well as the finding that children in the United States who are of Asian and Pacific Island ancestry have the highest incidence of KD in the country [ 5 , 6 , 8 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, recent studies from Europe, North America, and Australia have reported significantly lower annual incidence rates, ranging from 5–25/100,000 children < 5 years [ 4 – 8 ]. Notably, studies from the United States, United Kingdom, and Canada have demonstrated that the incidence of KD is higher among children of Asian descent compared with other ethnicities [ 8 – 11 ]. The etiology of KD and the reasons for observed differences in its incidence, presentation and outcomes in different patients and locations remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Unexpectedly high incidence of Kawasaki Disease in a Canadian Atlantic Province- an 11-year retrospective descriptive study

et al. 2023

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Background Kawasaki Disease (KD) is the leading cause of acquired heart disease in children in developed countries with a variable incidence worldwide. Previous studies reported an unexpectedly high incidence of KD in the Canadian Atlantic Provinces. The goals of our study were to validate this finding in the province of Nova Scotia and to carefully review patients’ characteristics and disease outcomes. Methods This was a retrospective review of all children < 16 years old from Nova Scotia diagnosed with KD between 2007–2018. Cases were identified using a combination of administrative and clinical databases. Clinical information was collected retrospectively by health record review using a standardized form. Results Between 2007–2018, 220 patients were diagnosed with KD; 61.4% and 23.2% met the criteria for complete and incomplete disease, respectively. The annual incidence was 29.6 per 100,000 children < 5 years. The male to female ratio was 1.3:1 and the median age was 3.6 years. All patients diagnosed with KD in the acute phase received intravenous immunoglobulin (IVIG); 23 (12%) were refractory to the first dose. Coronary artery aneurysms were found in 13 (6%) patients and one patient died with multiple giant aneurysms. Conclusion We have confirmed an incidence of KD in our population which is higher than that reported in Europe and other regions of North America despite our small Asian population. The comprehensive method to capture patients may have contributed to the detection of the higher incidence. The role of local environmental and genetic factors also deserves further study. Increased attention to regional differences in the epidemiology of KD may improve our understanding of this important childhood vasculitis.

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“…Although it is not clear what triggers them, it appears that Still’s disease and KD occur in the same age groups with a maximum of cases around the age of 2 to 4 years and rarer cases at adolescence and in young adults [ 17 , 18 , 19 , 20 ]. Both correspond to a deregulation of the innate immune response towards an excessive inflammation following a still unknown stimulation, coming from the airways or the digestive system.…”

Section: Still’s Disease and Kd How Much Are They Related?mentioning

confidence: 99%

Still’s Disease in the Constellation of Hyperinflammatory Syndromes: A Link with Kawasaki Disease?

Dusser

Koné‐Paut

2021

JCM

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Still’s disease and Kawasaki disease (KD) today belong to the group of cytokine storm syndromes, a pathophysiological set related to excessive activation of the innate immune response. We present here a personal vision of what can link these two diseases, taking up their concepts at their beginning. By their many clinical and physiopathological similarities, we conclude that they constitute a common spectrum whose fate is modified by subtle differences in terms of adaptive response that could, in part, be driven by genetic factors.

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Incidence and short-term outcomes of Kawasaki disease

Cited by 14 publications

References 39 publications

Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment

Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment

Unexpectedly high incidence of Kawasaki Disease in a Canadian Atlantic Province- an 11-year retrospective descriptive study

Still’s Disease in the Constellation of Hyperinflammatory Syndromes: A Link with Kawasaki Disease?

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