Kawasaki disease, autoimmune disorders, and cancer: a register-based study

Abstract

Kawasaki disease has well-described cardiovascular complications. However, the association to autoimmunity and cancer in the long term is not well described. We investigated theses associations using a registry-based matched cohort follow-up study of patients diagnosed with Kawasaki disease. Patients with Kawasaki disease were included and matched 1:5 to a population control group, matched by birth year, sex and incident month of the Kawasaki disease diagnosis. A total of 820 cases < 21 years of age were identified. Median age at diagnosis was 3 years. Median follow-up time was 12 years. Patients with KD were at higher risk of being diagnosed with ischaemic heart disease at 10 years (HR 39.94 (95% CI 5.00-319.28)) and 30 years (HR 8.33 (95% CI 3.03-22.91)). The 10-, 20-and 30-year risks of developing autoimmune disorders were HR 4.23 (95% CI 3.01-5.94), HR 3.23 (95% CI 2.44-4.29) and 2.83 (95% CI, 2.17-3.68), all p < 0.001. Cancer risk was increased after 30 years (HR 2.42 (95% CI, 1.09-5.34)). All-cause mortality after 35 years was also significantly increased (HR 3.14 (95% CI, 1.03-9.60)). Children with KD have increased long-term risks of ischaemic heart disease also of autoimmune disease and cancer, as well as an increased allcause mortality. The surprisingly increased risk of autoimmunity must be investigated further. What is known: • Kawasaki disease is characterized by acute vasculitis and inflammation that can affect the coronary arteries. • Anti-inflammatory medicine is effective in the acute stages of the disease. What is new: • Children with Kawasaki disease have an increased risk of developing autoimmune disease in the long term. • Kawasaki disease is associated with a slightly increased mortality rate driven by non-cardiovascular causes.

RETRACTED: Why are we vaccinating children against COVID-19?

“…In general, although almost all children fully recover, some of them later develop coronary artery dilation or aneurysm ( Sundel and Petty, 2011 ). Etiologically and pathologically, numerous studies indicate that KD is triggered by an abnormal autoimmune response caused by an infection ( Nielsen et al, 2021 ). The infection hypothesis is supported by epidemiology data showing that an infectious disease is involved at least as a starting point.…”

“…A rigorous follow-up to detect progressive stenosis, thrombosis and luminal occlusion that may lead to myocardial ischemia and infarction becomes mandatory ( Denby et al, 2017 ). Of equal importance, among other long-term outcomes, children with KD may have increased risks not only for ischemic heart disease, but also for autoimmune disorders, cancer as well as an increased all-cause mortality ( Nielsen et al, 2021 ).…”

Efficacy of Glucocorticoid plus Intravenous Immunoglobulin in Children with Immunoglobulin-Insensitive Kawasaki Disease

“…Kawasaki disease (KD), a mucocutaneous lymph node syndrome named after its discoverer (Kawasaki), is an acute febrile inflammatory disease that tends to occur among infants and children [ 1 , 2 ]. KD is the most common cause of acquired heart disease in children in developed countries and even leads to coronary artery aneurysms (CAA), elevating the risk of coronary artery thrombosis in the later stage [ 3 ].…”

Characterization of Inflammatory Factors and T Cell Subpopulations in a Murine Model of Kawasaki Disease Induced by Candida albicans Cell Wall Extracts (CAWS)

“…Nevertheless, the limited understanding of KD-related pathogens and pathogenic cells, coupled with the unclear molecular immune mechanisms involved in the pathogenesis of KD, hinder the development of more effective therapeutic strategies against KD. Moreover, tissue specimens from patients with KD are difficult to obtain [ 26 – 28 ]. Herein, we established a murine model of KD induced by CAWS and revealed the characteristics of inflammatory factors and T cell subpopulations during KD.…”