Kawasaki Disease and Allergic Diseases
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Published on: September 26, 2022
Po-Yu Huang1, Ying-Hsien Huang2, Mindy Ming-Huey Guo2,3
1Department of Traditional Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Insights
Children with Kawasaki disease (KD) have a higher likelihood of developing allergic rhinitis and urticaria. Early recognition and management of allergies are crucial for long-term care in KD patients.
Area of Science:
- Pediatrics
- Immunology
- Allergy
Background:
- Kawasaki disease (KD) is a leading cause of acquired heart disease in children, characterized by coronary vasculitis.
- The etiology of KD remains unknown, but its association with allergic diseases is gaining clinical interest.
- Systematic reviews on the link between KD and allergies are needed.
Purpose of the Study:
- To systematically review the current literature on the association between Kawasaki disease and allergic diseases.
- To synthesize evidence regarding the prevalence and impact of allergies in children with a history of KD.
Main Methods:
- A comprehensive literature search was conducted using PubMed, Cochrane, and Embase databases.
- The review included studies published up to August 2020, focusing on immune repertoire, clinical, and epidemiological data.
- Analysis of existing research to identify patterns and associations between KD and allergic conditions.
Main Results:
- KD shares some characteristics with infectious diseases, though allergies are typically triggered by allergens.
- Children with KD showed a higher incidence of allergic rhinitis persisting until age 17 compared to the general population and siblings.
- Individuals with a history of KD were more prone to developing urticaria in adolescence and adulthood.
Conclusions:
- This review confirms an increased incidence of allergic diseases, including allergic rhinitis, following Kawasaki disease.
- Allergic conditions warrant emphasis in the long-term management of patients with KD.
- Integrating allergy management strategies into the care of children with KD is recommended for improved outcomes.
Abstract:
Background: Kawasaki disease (KD) is an inflammatory disorder with an unknown etiology. It is the leading cause of acquired heart disease, which leads to coronary vasculitis among children. Studies of frequent manifestation of allergic diseases in children with KD have been the subject of mounting clinical interest. However, evidence supporting the association between KD and allergies has yet to be systematically reviewed. Methods: In this article, we reviewed current literature regarding the association between KD and allergic diseases. References for this review were identified through searches of PubMed, Cochrane, and Embase through the end of August 2020. Results: The results of the analyses of immune repertoire, clinical, and epidemiological studies have indicated some of the characteristics of infectious disease for KD. Although some allergic disorders, such as asthma, may be exacerbated by viral infections, allergies are typically caused by an allergen that triggers an immune response, with the potential involvement of type 2 inflammation and immune disturbances leading to tissue remodeling in genetically susceptible hosts. The effect of intravenous immunoglobulin is multi-faceted and results in a decrease in activating Fc gamma receptor IIA and an increase in anti-inflammatory eosinophils. The findings from this review demonstrate that children who have suffered from KD are more likely to have allergic rhinitis than the general population and their siblings, a condition that lasts until the age of 17. When followed up as teenagers and adults, children with KD are more likely to develop urticaria. Conclusions: This review supports that allergic diseases, such as allergic rhinitis, have been demonstrated to increase following KD. Therefore, the importance of allergic diseases in patients with KD should be emphasized in long-term care. Interventions that include strategies for managing allergies in children with KD would be beneficial.
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