Understanding More About Kawasaki Disease

Kawasaki disease in children did not appear to mean later heart problems

(RxWiki News) Sometimes it can be difficult to learn enough about diseases that are fairly rare. Kawasaki is one such disease, but doctors are learning more.

A recent study found that having Kawasaki disease did not appear to put most children at a higher risk for later heart problems.

Kawasaki disease is a rare autoimmune disease that usually occurs in children under 5 years old. The disease affects children's lymph nodes and blood vessels, so the researchers wanted to know if any possible long-term impact to children's hearts might result.

Only about 19 out of every 100,000 children experience the condition, which is so far not preventable.

"Ask your child's doctor about Kawasaki disease treatment."

This study, led by Taylor J. Holve, MD, of the Department of Cardiology at Kaiser San Francisco Medical Center, looked at the possible long-term effects of Kawasaki disease.

While most children recover fairly quickly, clinicians don't know a lot about the possible long-term effects of the condition.

These researchers therefore compared the long-term outcomes of 546 children who had experienced Kawasaki disease with 2,218 children who had not.

All the children were at least 15 years old for the study (some up to 21), and those who had Kawasaki disease had had it when they were 5 years old or younger.

An average of 15 years of follow-up was available across all the participants.

The children without Kawasaki disease were matched (four without the disease for every one with the disease) to be similar to those who had the disease in terms of age, sex, geographic location and how long they had been a part of the Kaiser healthcare system.

Among the children who had Kawasaki disease, 79 percent had received intravenous immunoglobulin, a standard treatment for the condition.

Five percent of them had a coronary aneurysm, in which the coronary artery is abnormally enlarged. However, over the full length of the study, only two of the children who had Kawasaki disease had any kind of cardiovascular event.

Meanwhile, seven of the children who had never had Kawasaki disease experienced a cardiovascular event.

These events could have included a range of conditions, such as heart failure, acute coronary syndrome, an aneurysm in the aorta (a major valve in the heart) or death.

Therefore, children who had had Kawasaki syndrome in general did not appear to be at greater risk for later heart problems. However, if the children were among the small number of Kawasaki disease patients who had a coronary aneurysm, they did have a higher risk of later heart problems.

According to Sarah Samaan, MD, a cardiologist with Legacy Heart Center in Dallas-Fort Worth, this study is reassuring to children who have had Kawasaki disease and their parents.

"Unfortunately, there is no information yet about heart disease that might develop in adulthood," she added. "For example, are kids who get Kawasaki at higher risk for garden variety coronary artery disease in middle age or older? Obviously, that would require a much longer time frame," she said.

Dr. Samaan said there is still research to be done to better understand what these children can expect.

"Although aneurysms are uncommon, it would also be useful to know about the long-term prognosis of having a coronary artery aneurysm," she said.

"Since those kids were more likely to have problems in childhood, what can we expect as they grow older? We don't yet know whether routine heart testing would be useful in these individuals," Dr. Samaan said. "Thankfully it remains a very uncommon illness, and one for which treatment has improved a great deal over the years."

This study was published January 20 in the journal Pediatrics. The research was funded by the Kaiser Foundation Research Institute Community Benefits Grant Program. The authors reported no potential conflicts of interest.

Review Date: 
January 19, 2014