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BCG and Kawasaki disease in Mexico and Japan
Luisa Berenise Gamez-Gonzalez1, Hiromichi Hamada2, Beatriz Adriana Llamas-Guillen3
1a Department of Allergy and Clinical Immunology , Hospital Infantil de Especialidades de Chihuahua , Chihuahua , Mexico.
Insights
BCG reactivation is a specific early sign in Kawasaki Disease (KD), affecting 30-50% of patients. Understanding its pathophysiology may improve KD diagnosis and management.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Kawasaki Disease (KD) is a pediatric illness characterized by inflammation of blood vessels.
- BCG reactivation, a reaction at the Bacillus Calmette-Guérin vaccination site, is observed in a significant portion of KD patients.
- The exact mechanisms behind BCG reactivation in KD remain unclear.
Observation:
- This study presents two cases of KD with severe BCG reactions, one from Japan and one from Mexico.
- The authors reviewed BCG vaccination policies in Japan and Mexico.
- BCG vaccine coverage is high globally (88%), with variations in strains and administration methods.
Findings:
- BCG reactivation is a highly specific early indicator for Kawasaki Disease.
- Severe BCG reactions, including tuberculid, have been reported in KD patients.
- Differences in BCG strains and administration may influence the incidence and severity of BCG reactions in KD.
Implications:
- BCG reaction at the inoculation site may serve as a crucial diagnostic sign for Kawasaki Disease.
- Further research into the pathophysiology of BCG reactivation in KD is warranted.
- Understanding BCG reactions could lead to improved diagnostic strategies for Kawasaki Disease.
Abstract:
Dr. Tomisaku Kawasaki was the first to describe BCG reactivation in Kawasaki Disease (KD), and this sign is present in about 30-50% of KD patients. It is a very specific early sign of the disease and although it has been recognized for decades, its pathophysiology continues to be an enigma. Recently, Yamada et al. reported a severe BCG reaction with tuberculid in 2 Japanese KD patients. We present 2 cases with KD and severe BCG reaction, one from Japan and the other from Mexico and review the policies of administration of BCG in both countries. The BCG vaccine has a worldwide coverage of 88%. Differences in BCG strains and methods of administration may influence BCG reactions in KD. The BCG reaction in the inoculation site may represent the most useful sign in KD.
