Kawasaki Disease and Allergic Diseases

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.

An AI-guided signature reveals the nature of the shared proximal pathways of host immune response in MIS-C and Kawasaki disease

“…Eosinopenia appears to be a notable shared feature between MIS-C and COVID-19 52 , but not KD. These findings are consistent with the fact that KD is known to present with higher (not lower) eosinophil counts, Th2 cytokines IL-4, IL-5, and eosinophil cationic protein (ECP) [53][54][55][56][57] . As in the case of thrombocytopenia, persistent eosinopenia after admission correlated with COVID-19 severity and low rates of recovery 58 .…”

Desquamation in Kawasaki Disease

“…It is not known whether the difference between the formation mechanism of low and high exfoliation is related to the role of type 2 inflammation plays in CAA. The absolute counts of low-affinity immunoglobulin E receptor CD23+ macrophages/monocytes in KD patients with CAA were lower than those in patients without CAA [ 20 ]. Post-IVIG eosinophilia was associated with the lower rate of CAA [ 21 ].…”

The Complementary Relationship Between Echocardiography and Multi-Slice Spiral CT Coronary Angiography in the Diagnosis of Coronary Artery Thrombosis in Children With Kawasaki Disease

“…As for the means of examination, the advantage of ECHO is that it is non-invasive, convenient, and repeatable (13)(14)(15). The limitation of ECHO includes (i) that because the heart is spherical and surrounded by lungs, ECHO only examines the internal structure of the heart and provides limited evaluation on distal vessels, left circumflex artery, and a poor acoustic window in growing children (16); and (ii) for which the diagnosis of coronary artery calcification and stenosis is frequently missed when using ECHO (17).…”