Dhrubajyoti Sharma, DM (Pediatric Clinical Immunology and Rheumatology) Associate Professor, Department of Pediatrics, Jorhat Medical College, Jorhat, Assam
Juvenile Idiopathic Arthritis (JIA) and Kawasaki disease (KD) are two distinct diseases. However, they share many clinical features and biological markers such as IL-1β and IL-6. Arthritis can develop in approximately 7.5% patients with KD. Coronary artery abnormality is more frequent in patients with KD-related arthritis.
Study in focus: Impact of Kawasaki disease on juvenile idiopathic arthritis in real-world patients: A population-based cohort study
In a population based longitudinal study in Taiwan by Liao et al on 7009 patients with KD and 56072 patients without KD reported that, patients with KD had 2.02 times higher risk of development of JIA than in patients without KD (95% CI: 1.12-3.67, p=0.0205). The risk was greater in children of 6-18 years with KD than in children of 0-3 years with KD (95% CI: 1.49–5.34, p = 0.0015). Female patients with KD had 3.01 fold increased risk of JIA than female patients without KD (95% CI: 1.38-6.54, p=0.005). However, this risk was regardless of race, co-morbidities and urbanization of the study subjects.
This is the largest epidemiological study which probes the association of KD-JIA. The association of JIA and KD indicates that these two diseases can have common immunologic mechanism and cytokine profile and probably be treated by similar biologic agents like anti-IL-1 agents. The risk of JIA should be explained to the parents of KD and JIA should be managed appropriately in such patients.
Reference:
Liao L-C, Fu Y-H, Chuang C-M, Liao P-L, Wei JC-C and Fu Y-C (2022) Impact of Kawasaki disease on juvenile idiopathic arthritis in real-world patients: A population-based cohort study. Front. Immunol. 13:1025553.doi: 10.3389/fimmu.2022.1025553