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Kawasaki Disease and Atopic Diseases: A Systematic Review and Meta-Analysis of Observational Studies
Zihan Wang1,2, Jintao Zhang3,4, Hao Yan5
1Department of Respiratory, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Insights
Kawasaki disease (KD) is linked to four common atopic diseases. Allergic conjunctivitis and asthma show the strongest association with KD, offering potential insights into the disease
Area of Science:
- Pediatric immunology
- Cardiovascular research
- Allergy and immunology
Background:
- The exact causes of Kawasaki disease (KD), a significant inflammatory cardiovascular condition, remain largely unknown.
- Previous observational studies suggest a potential link between KD and atopic diseases, warranting further investigation.
Approach:
- A systematic review and meta-analysis were conducted, searching MEDLINE and EMBASE databases from inception to May 2021.
- Thirteen observational studies comprising 12,651 KD cases and 170,708 controls were analyzed.
- Random-effects models were used to pool odds ratios (OR) and assess heterogeneity.
Key Points:
- KD was significantly associated with allergic rhinitis (OR 1.69), asthma (OR 1.72), allergic conjunctivitis (OR 1.95), and atopic dermatitis (OR 1.35) in cross-sectional studies.
- In case-control and cohort studies, KD showed associations with allergic rhinitis (OR 1.35), asthma (OR 1.40), allergic conjunctivitis (OR 1.74), and atopic dermatitis (OR 1.39).
- Allergic conjunctivitis and asthma demonstrated the highest correlations with Kawasaki disease.
Conclusions:
- Kawasaki disease is associated with four common atopic conditions.
- The strong correlation between allergic conjunctivitis and asthma with KD may guide future research into the etiology of Kawasaki disease.
Introduction:
The etiology of Kawasaki disease (KD), an inflammatory and cardiovascular disorder, remains largely unexplained after more than 50 years of intensive research. In recent years, the association between KD and atopic diseases had been explored by some observational studies. We systematically reviewed and summarized the literature on the relationship between KD and atopic diseases.
Methods:
MEDLINE and EMBASE were searched to identify observational studies on the association between KD and atopic diseases from inception to May 2021. Odds ratio (OR) was pooled using random-effects models. Heterogeneity was assessed using the I2 and Cochran Q statistics. Primary outcomes were to compare the prevalence of KD among individuals with atopic diseases to nonatopic disease controls and the prevalence of atopic diseases among individuals with KD to non-KD controls.
Results:
Thirteen studies, including 12,651 cases and 170,708 controls, were included in this meta-analysis. In cross-sectional studies, KD was associated with allergic rhinitis (n = 6; OR, 1.69; 95% CI, 1.52-1.87), asthma (n = 3; OR, 1.72; 95% CI, 1.38-2.14), allergic conjunctivitis (n = 2; OR, 1.95; 95% CI, 1.68-2.27), and atopic dermatitis (n = 3; OR, 1.35; 95% CI, 1.22-1.49). In case-control and cohort studies, KD was associated with allergic rhinitis (n = 3; OR, 1.35; 95% CI, 1.28-1.43), asthma (n = 8; OR, 1.40; 95% CI, 1.19-1.65), allergic conjunctivitis (n = 1; OR, 1.74; 95% CI, 1.45-2.09), and atopic dermatitis (n = 3; OR, 1.39; 95% CI, 1.26-1.53).
Conclusion:
KD diagnosed was associated with four common atopic diseases. Among the four allergic diseases, allergic conjunctivitis and asthma have the highest correlation with KD, which may provide a direction for exploring the etiology of KD.
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