From the Division of Public Health.
Division of General Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.
Pediatr Infect Dis J. 2021 Jun 1;40(6):531-536. doi: 10.1097/INF.0000000000003074.
Some patients with Kawasaki disease (KD) have siblings who developed the same disease. Using a large-scale epidemiologic dataset, the present study aimed to determine the clinical characteristics of this population.
We analyzed 89,725 patients diagnosed with KD during 2011-2018 who were registered in the nationwide Japanese KD survey database. Multivariable logistic regression analyses were performed to determine factors associated with sibling history of KD.
Of the 89,725 patients, 1777 (2%) had sibling history of KD. Annual prevalence ranged from 1.5% to 2.3% during the study period and showed a tendency toward an increasing trend. Patients with recurrent KD and parental history of KD were significantly associated with sibling history of KD (adjusted odds ratio [95% confidence interval] = 2.15 [1.82-2.54] and 2.64 [2.02-3.47], respectively). Although patients with a sibling history of KD were significantly associated with initial intravenous immunoglobulin treatment resistance (1.14 [1.02-1.28]), no significant association was found between sibling history and coronary artery abnormality development. Among patients with a sibling history of KD, male patients were less likely to have recurrent KD than female patients (0.68 [0.49-0.96]).
The significant association between sibling history and parental history may indicate genetic susceptibility to KD onset. Among those with a sibling history, recurrent KD was more likely to occur in female patients. Further studies focusing on this population may contribute toward identification of the cause of KD onset.
一些川崎病(KD)患者的兄弟姐妹也患有同样的疾病。本研究利用大规模的流行病学数据集,旨在确定该人群的临床特征。
我们分析了 2011-2018 年期间在全国性日本 KD 调查数据库中登记的 89725 例 KD 患者。采用多变量逻辑回归分析确定与 KD 家族史相关的因素。
在 89725 例患者中,有 1777 例(2%)有 KD 家族史。研究期间,年患病率在 1.5%至 2.3%之间,呈上升趋势。复发性 KD 和父母 KD 病史与 KD 家族史显著相关(调整后的优势比[95%置信区间]分别为 2.15[1.82-2.54]和 2.64[2.02-3.47])。尽管有 KD 家族史的患者与初始静脉注射免疫球蛋白治疗抵抗显著相关(1.14[1.02-1.28]),但 KD 家族史与冠状动脉异常发展之间无显著相关性。在有 KD 家族史的患者中,男性患者发生复发性 KD 的可能性低于女性患者(0.68[0.49-0.96])。
KD 家族史与父母 KD 病史之间的显著关联可能表明 KD 发病存在遗传易感性。在有 KD 家族史的患者中,复发性 KD 更可能发生在女性患者中。进一步针对该人群的研究可能有助于确定 KD 发病的原因。