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Atopic asthma as a potentially significant but unrecognized risk factor for Kawasaki disease in children
Bong Seok Choi1,2, Editt Nikoyan Taslakian3, Chung-Il Wi2
1Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, South Korea.
Insights
Children with atopic asthma may have a higher risk of developing Kawasaki disease (KD). This study suggests a link between specific asthma phenotypes and increased KD odds, warranting further investigation into underlying mechanisms.
Area of Science:
- Pediatric Immunology
- Respiratory Medicine
- Infectious Diseases
Background:
- Childhood asthma is linked to various infections.
- The association between asthma and Kawasaki disease (KD) risk is not well-established.
- Understanding this relationship could inform pediatric health strategies.
Purpose of the Study:
- To investigate the association between asthma status and asthma phenotypes with the risk of Kawasaki disease (KD).
- To explore specific asthma phenotypes, including atopic asthma, in relation to KD incidence.
Main Methods:
- Population-based retrospective case-control study.
- Utilized KD cases and matched controls from 1979-2016.
- Assessed asthma using Predetermined Asthma Criteria (PAC) and Asthma Predictive Index (API).
Main Results:
- Asthma defined by both PAC and API showed a significant association with increased KD odds (OR 4.3).
- Asthma with eosinophilia (≥4%) was strongly linked to higher KD risk (OR 6.7).
- Asthma defined by API also indicated a significant association with KD (OR 4.7).
Conclusions:
- Atopic asthma may be associated with an elevated risk of Kawasaki disease.
- Further prospective research is recommended to elucidate the biological mechanisms.
- Findings highlight a potential link between specific asthma profiles and KD susceptibility.
Objectives:
Childhood asthma is known to be associated with risks of both respiratory and non-respiratory infections. Little is known about the relationship between asthma and the risk of Kawasaki disease (KD). We assessed associations of asthma status and asthma phenotype (e.g. atopic asthma) with KD.
Methods:
We performed a population-based retrospective case-control study, using KD cases between January 1, 1979, and December 31, 2016, and two matched controls per case. KD cases were defined by the American Heart Association diagnostic criteria. Asthma status prior to KD (or control) index dates was ascertained by the two asthma criteria, Predetermined Asthma Criteria (PAC) and Asthma Predictive Index (API, a surrogate phenotype of atopic asthma). We assessed whether 4 phenotypes (both PAC + and API+; PAC + only; API + only, and non-asthmatics) were associated with KD.
Results:
There were 124 KD cases during the study period. The group having both PAC + and API + was significantly associated with the increased odds of KD, compared to non-asthmatics (odds ratio [OR] 4.3; 95% CI: 1.3 - 14.3). While asthma defined by PAC was not associated with KD, asthma defined by PAC positive with eosinophilia (≥4%) was significantly associated with the increased odds of KD (OR: 6.7; 95% CI: 1.6 - 28.6) compared to non-asthmatics. Asthma status defined by API was associated with KD (OR = 4.7; 95% CI: 1.4-15.1).
Conclusions:
Atopic asthma may be associated with increased odds of KD. Further prospective studies are needed to determine biological mechanisms underlying the association between atopic asthma and increased odds of KD.
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