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Incidence of chronic immune-mediated inflammatory diseases after diagnosis with Kawasaki disease: a population-based

Stephen G Fung1,2, Richard Webster1, M Ellen Kuenzig1,2,3

  • 1Children's Hospital of Eastern Ontario Research Institute.

Rheumatology (Oxford, England)
|September 9, 2021
PubMed

Insights

Children with Kawasaki disease (KD) have an increased risk of developing arthritis, but not other immune-mediated inflammatory diseases (IMIDs). Healthcare providers should monitor for arthritis in children after a KD diagnosis.

Area of Science:

  • Pediatric Rheumatology
  • Immunology
  • Epidemiology

Background:

  • Kawasaki disease (KD) is a childhood vasculitis causing multi-organ inflammation.
  • The risk of subsequent immune-mediated inflammatory diseases (IMIDs) after KD is not fully understood.

Purpose of the Study:

  • To determine the risk of IMIDs, including arthritis, type 1 diabetes, IBD, autoimmune liver disease, primary sclerosing cholangitis, and multiple sclerosis, following a KD diagnosis.

Main Methods:

  • A population-based cohort study in Ontario, Canada, matched 3753 children with KD to 18749 controls.
  • Health administrative data were used to assess IMID incidence after KD resolution, employing 3- and 12-month washout periods.

Main Results:

  • An elevated risk of arthritis was observed in KD patients (IRR 8.07) compared to controls.
  • Overall IMID incidence was elevated in KD patients (IRR 2.58), primarily driven by arthritis.
  • No increased risk for diabetes, IBD, autoimmune liver disease, primary sclerosing cholangitis, or multiple sclerosis was found.

Conclusions:

  • Children diagnosed with KD face a higher risk of arthritis post-diagnosis.
  • No increased risk for other IMIDs was identified in KD patients.
  • Monitoring for arthritis is recommended for children following a Kawasaki disease diagnosis.
Abstract

Keywords:
IBDKawasaki diseasearthritisautoimmune hepatitishealth administrative datamultiple sclerosispediatricsprimary sclerosing cholangitisroutinely collected health datatype 1 diabetes mellitus

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