Incidence rate of recurrent Kawasaki disease and related risk factors: from the results of nationwide surveys of Kawasaki disease in Japan

Hirata, Shinichi; Nakamura, Yosikazu; Yanagawa, Hiroshi

doi:10.1111/j.1651-2227.2001.tb00253.x

Cited by 87 publications

(97 citation statements)

References 15 publications

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“…We have not identified factors associated with an increased odds of KD recurrence, in contrast with other studies. 9,16,17 Finally, the present study found similar outcomes between the index and recurrent KD episodes, which is in contrast to a previous study that reported an increased odds of coronary artery aneurysms associated with the recurrent KD episode.…”

Section: Discussioncontrasting

confidence: 56%

“…Previous studies in Japan reported that approximately 1% of KD patients had a positive family history of KD, and siblings of an affected child have a 10-fold higher risk of having KD. 5,9,10 According to several nationwide surveys of KD in Japan, the proportion of patients experiencing recurrence of KD is 3-4%. 2,5 Early epidemiological studies in the USA have reported a risk of recurrence of 0.8%, 3,4 although these estimates have yet to be updated and may not be accurate in an era with an increasing incidence of KD and improved recognition.…”

Section: Rate Of Kd Recurrencementioning

confidence: 99%

“…16 No other risk factors for disease recurrence have been identified in populationbased studies. 9,16,17 Previous studies have also shown that patients having a second KD episode have a higher likelihood of coronary artery abnormalities compared with patients undergoing an initial or index episode. 18,19 We sought to determine the rate of KD recurrence in Ontario and to identify potential factors associated with increased risk of recurrence.…”

mentioning

confidence: 99%

“…6 The phenomenon of recurrence of KD, along with higher risk of KD in first-degree relatives, has suggested a potential genetic predisposition to KD. 5,[7][8][9][10] Recent studies have uncovered potential genetic polymorphisms associated with either higher risk of KD [11][12][13] or increased frequency of coronary artery abnormalities after KD. 14,15 Some reports have shown that younger children and children who received i.v.…”

mentioning

confidence: 99%

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Rate, associated factors and outcomes of recurrence of Kawasaki disease in Ontario, Canada

Chahal

Somji

Manlhiot

et al. 2012

Pediatrics International

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Background: Previous studies on recurrence of Kawasaki disease (KD) have mostly been limited to Japan, which has an incidence of KD 8-10-fold higher than North America. The aim of the present study was to determine the rate of KD recurrence for patients in Ontario, to identify factors potentially associated with increased odds of recurrence, and to compare the clinical course and outcomes of index and recurrent KD episodes. Methods: Review was undertaken of all patients with recurrence of KD identified in Ontario, Canada, from 1995 to 2006. All patients with recurrence of KD (defined as at least three clinical signs of KD in addition to fever 35 days), presenting 314 days after the return to baseline from the index episode were included. Results: A total of 1010 patients were followed for 5786 patient-years. During this period a total of 17 recurrent episodes in 16 patients were identified at a median of 1.5 years after the initial episode (2 weeks-5 years). Rate of recurrence of KD was 2.9 episodes/1000 patient-years, which is higher than the expected annual incidence of KD in the same age group (26.2/100 000 per year). No factors associated with increased risk of recurrence were identified, perhaps due to the small number of events. Clinical course and outcomes of the index and recurrent KD episodes were similar. Conclusions:A previous history of KD should increase the index of suspicion for future episodes of KD to allow for rapid recognition, treatment and to achieve optimal outcomes.Key words coronary artery abnormalities, genetics, Kawasaki disease, recurrence.Recurrence after Kawasaki disease (KD) is a well-established phenomenon. 1 Recurrence of KD is thought to affect approximately 4% of children who have had KD in Japan.2 Populationbased studies conducted in the early 1980s have established the prevalence of recurrence of KD in the USA at <1%; these estimates have not been re-evaluated since. 3,4 Estimates have also shown that the risk of having a second episode of KD for children with a previous history of KD is higher than the risk for children in the general population of having an initial episode of KD.

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Section: Discussioncontrasting

confidence: 56%

Section: Rate Of Kd Recurrencementioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Rate, associated factors and outcomes of recurrence of Kawasaki disease in Ontario, Canada

Chahal

Somji

Manlhiot

et al. 2012

Pediatrics International

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show abstract

“…Maternal immunoglobulin G may offer some protection to young infants and this protection diminishes as levels of maternal antibodies decrease (Burns & Glode, 2004). d. The 3-5 % of recurrency among cases in Japan, that may suggest either an aberrant immune response in this particular group of patients or the existence of more than one infectious agents responsible for the disease (Hirata et al, 2001). e. The clinical presentation of the disease with fever, cervical lymphadenitis, exanthema and conjunctivitis that resembles other infectious diseases such as scarlet fever and toxic shock syndrome (TSS).…”

Section: Aetiologymentioning

confidence: 99%