Incidence Survey of Kawasaki Disease in 1997 and 1998 in Japan

Abstract

ABSTRACT. Objective. To describe the results of a nationwide epidemiologic survey of Kawasaki disease for the 2-year period 1997 and 1998.Design. We sent a questionnaire to all hospitals with 100 beds or more throughout Japan (2663 hospitals) requesting data on patients with Kawasaki disease. Study items included name, sex, date of birth, date of initial hospital visit, diagnosis, address, recurrence, sibling cases, gammaglobulin treatment, and cardiac lesion in the acute stage or 1 month after onset.Results. Of the 2663 hospitals, 68.5% responded, reporting 12 966 patients-7489 males and 5477 females. Of the total patients reported, 6373 (incidence rate of 108.0 per 100 000 children <5 years old) occurred in 1997, and 6593 (111.7) in 1998. More than one half of the patients (54.9%) were <2 years old and 81.6% were <4 years old. In males, the incidence rates of cardiac lesions were 27.2 in the acute stage and 10.1 a month after onset. In females, the rates were 16.7 and 5.2, respectively. The incidence rates of cardiac lesions were highest in the youngest age group (<6 months old) both in the acute stage and 1 month after onset. The rates decreased with increasing ages. Although frequency of giant aneurysms was not high at the acute stage, it did not decrease 1 month after onset.Conclusion. The incidence rates have been steadily increasing for 11 years since 1987. The rate in 1998 was over 1.5 times higher than that in 1987. The age and sex distributions were identical in each survey. Although most of the cardiac lesions at the acute stage decreased to half or less 1 month after onset, giant aneurysms did not decrease and existed persistently after 1 month. Pediatrics 2001;107(3). URL: http://www.pediatrics.org/ cgi/content/full/107/3/e33; Kawasaki disease, epidemiology, incidence, nationwide survey.

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease

“…[5][6][7][8] Kawasaki disease is markedly more prevalent in Japan and in children of Japanese ancestry, with an annual incidence of Ϸ112 cases per 100 000 children Ͻ5 years old. 9 In the United States, the incidence of Kawasaki disease has been best estimated from hospital discharge data. 10,11 An estimated 4248 hospitalizations associated with Kawasaki disease occurred in the United States in Figure 1.…”

CD40 ligand gene and Kawasaki disease

“…The Japanese nationwide surveys of KD incidence have documented that male children are more often affected and have a higher risk for cardiac complications. 7 Unlike adults, no differences in lifestyle or environment are conceivable in early childhood. Thus, it seems rational to postulate that one of the genes influencing KD susceptibility and disease severity is located on the X chromosome.…”

“…Initially, we performed affected sib-pair linkage analysis and have identified four possible loci, 12q24, 7p15, 19q13.3, and Xq26 (Onouchi et al, manuscript in preparation). The fact that male children are predominantly affected with KD (male/female ¼ 1.4) 7 suggests that a gene on the X chromosome could be implicated in KD susceptibility.…”

Kawasaki Disease: The Coronary Affection Perspective

“…The fact that some ethnic groups are at higher risk for KD than others suggests that there may be ethnicity-related genetic differences or possibly shared environmental exposures that make some individuals more susceptible to KD [2,16].…”