Key result
Children with Kawasaki disease were significantly more likely to have been admitted to the hospital at least once with an infection compared to matched controls (50.8% vs 35.1%; OR 1.9).
Why the study?
Do Kawasaki disease patients and their relatives have different rates of hospitalization for infection, asthma, and allergy compared to matched controls?
Case-Control (n=6,309)
Do Kawasaki disease patients and their relatives have different rates of hospitalization for infection, asthma, and allergy compared to matched controls?
Odds Ratio: 1.9 (95% CI 1.4–2.6)
Absolute Event Rate: 50.8% vs 35.1%
p-value: p=7.2x10^-26
Children with Kawasaki disease and their relatives have higher rates of hospital admissions for infections and asthma/allergy, suggesting shared heritable immune factors.
May warrant infection surveillance in Kawasaki disease; leaves open whether shared heritable immune factors explain links to asthma/allergy in patients and relatives.
BACKGROUND: Kawasaki disease results from an abnormal immunological response to one or more infectious triggers. We hypothesised that heritable differences in immune responses in Kawasaki disease-affected children and their families would result in different epidemiological patterns of other immune-related conditions. We investigated whether hospitalisation for infection and asthma/allergy were different in Kawasaki disease-affected children and their relatives. METHODS/MAJOR FINDINGS: We used Western Australian population-linked health data from live births (1970-2006) to compare patterns of hospital admissions in Kawasaki disease cases, age- and sex-matched controls, and their relatives. There were 295 Kawasaki disease cases and 598 age- and sex-matched controls, with 1,636 and 3,780 relatives, respectively. Compared to controls, cases were more likely to have been admitted at least once with an infection (cases, 150 admissions (50.8%) vs controls, 210 admissions (35.1%); odds ratio (OR) = 1.9, 95% confidence interval (CI) 1.4-2.6, P = 7.2×10⁻⁶), and with asthma/allergy (cases, 49 admissions (16.6%) vs controls, 42 admissions (7.0%); OR = 2.6, 95% CI 1.7-4.2, P = 1.3×10⁻⁵). Cases also had more admissions per person with infection (cases, median 2 admissions, 95% CI 1-5, vs controls, median 1 admission, 95% CI 1-4, P = 1.09×10⁻⁵). The risk of admission with infection was higher in the first degree relatives of Kawasaki disease cases compared to those of controls, but the differences were not significant. CONCLUSION: Differences in the immune phenotype of children who develop Kawasaki disease may influence the severity of other immune-related conditions, with some similar patterns observed in relatives. These data suggest the influence of shared heritable factors in these families.
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Webster et al. (2011) conducted a case-control in Kawasaki disease (n=6,309). Kawasaki disease vs. Age- and sex-matched controls without Kawasaki disease was evaluated on Hospital admission with an infection (OR 1.9, 95% CI 1.4-2.6, p=7.2x10^-26). Children with Kawasaki disease were significantly more likely to have been admitted to the hospital at least once with an infection compared to matched controls (50.8% vs 35.1%; OR 1.9).
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