Associations of infection burden with Kawasaki disease in a population-based setting during 30 years
Objectives The objective of this study was to investigate the role of infections in the pathogenesis of Kawasaki disease.Methods The investigation was a nationwide epidemiological case-control study, comprising all cases of Kawasaki disease diagnosed in Sweden 1987–2018. Controls were randomly sampl...
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BMJ Publishing Group
2025-01-01
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| Online Access: | https://rmdopen.bmj.com/content/11/1/e005160.full |
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| author | Johannes Mofors Håkan Eliasson Gunnar Bergman Sven-Erik Sonesson Marie Wahren-Herlenius Göran Elinder André Rudolph Bodil Schiller |
| author_facet | Johannes Mofors Håkan Eliasson Gunnar Bergman Sven-Erik Sonesson Marie Wahren-Herlenius Göran Elinder André Rudolph Bodil Schiller |
| author_sort | Johannes Mofors |
| collection | DOAJ |
| description | Objectives The objective of this study was to investigate the role of infections in the pathogenesis of Kawasaki disease.Methods The investigation was a nationwide epidemiological case-control study, comprising all cases of Kawasaki disease diagnosed in Sweden 1987–2018. Controls were randomly sampled from the general population, matched on sex, age, and area of residency. Data on infections were obtained from the Swedish National Patient Register, which prospectively collects data on all Swedish residents. Infections were classified by organ system, infectious agent and by temporal proximity to Kawasaki disease diagnosis date. Prescription of antibiotics and infections in family members were also considered in separate analyses.Results The study comprised n=1774 (61% male) cases and n=17 731 controls. Overall, a history of infections was associated with Kawasaki disease with an OR of 2.3 (95% CI 2.0 to 2.5). Respiratory, skin, urogenital and gastrointestinal tract infections were all associated with Kawasaki disease. Temporal stratification revealed a prominent clustering of infections during the weeks before a Kawasaki diagnosis, but also higher frequencies of infections several months preceding Kawasaki disease with OR ranging from 5.1 (95% CI 3.6 to 7.1) 15–28 days to 1.3 (95% CI 1.1 to 1.6) 181–365 days prior Kawasaki disease. A dose–response relationship was observed, with repeated infections associating with higher ORs of Kawasaki.Conclusions The findings suggest that infections are closely linked with Kawasaki disease, and with a wider temporal association than previously known. Further, the data imply that many different agents may induce the disease. |
| format | Article |
| id | doaj-art-4ed69198b85747728e224830a928950f |
| institution | Kabale University |
| issn | 2056-5933 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj-art-4ed69198b85747728e224830a928950f2025-01-22T08:10:10ZengBMJ Publishing GroupRMD Open2056-59332025-01-0111110.1136/rmdopen-2024-005160Associations of infection burden with Kawasaki disease in a population-based setting during 30 yearsJohannes Mofors0Håkan Eliasson1Gunnar Bergman2Sven-Erik Sonesson3Marie Wahren-Herlenius4Göran Elinder5André Rudolph6Bodil Schiller7Department of Medicine, Karolinska Institutet, Stockholm, SwedenPediatric Cardiology Unit, Karolinska Universitetssjukhuset, Stockholm, SwedenDepartment of Pediatric Cardiology Stockholm-Uppsala, Karolinska University Hospital, Stockholm, SwedenDepartment of Medicine, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine, Karolinska Institutet, Stockholm, SwedenDepartment of Clinical Science and Education, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine, Karolinska Institutet, Stockholm, SwedenSödersjukhuset, Region Stockholm, Stockholm, SwedenObjectives The objective of this study was to investigate the role of infections in the pathogenesis of Kawasaki disease.Methods The investigation was a nationwide epidemiological case-control study, comprising all cases of Kawasaki disease diagnosed in Sweden 1987–2018. Controls were randomly sampled from the general population, matched on sex, age, and area of residency. Data on infections were obtained from the Swedish National Patient Register, which prospectively collects data on all Swedish residents. Infections were classified by organ system, infectious agent and by temporal proximity to Kawasaki disease diagnosis date. Prescription of antibiotics and infections in family members were also considered in separate analyses.Results The study comprised n=1774 (61% male) cases and n=17 731 controls. Overall, a history of infections was associated with Kawasaki disease with an OR of 2.3 (95% CI 2.0 to 2.5). Respiratory, skin, urogenital and gastrointestinal tract infections were all associated with Kawasaki disease. Temporal stratification revealed a prominent clustering of infections during the weeks before a Kawasaki diagnosis, but also higher frequencies of infections several months preceding Kawasaki disease with OR ranging from 5.1 (95% CI 3.6 to 7.1) 15–28 days to 1.3 (95% CI 1.1 to 1.6) 181–365 days prior Kawasaki disease. A dose–response relationship was observed, with repeated infections associating with higher ORs of Kawasaki.Conclusions The findings suggest that infections are closely linked with Kawasaki disease, and with a wider temporal association than previously known. Further, the data imply that many different agents may induce the disease.https://rmdopen.bmj.com/content/11/1/e005160.full |
| spellingShingle | Johannes Mofors Håkan Eliasson Gunnar Bergman Sven-Erik Sonesson Marie Wahren-Herlenius Göran Elinder André Rudolph Bodil Schiller Associations of infection burden with Kawasaki disease in a population-based setting during 30 years RMD Open |
| title | Associations of infection burden with Kawasaki disease in a population-based setting during 30 years |
| title_full | Associations of infection burden with Kawasaki disease in a population-based setting during 30 years |
| title_fullStr | Associations of infection burden with Kawasaki disease in a population-based setting during 30 years |
| title_full_unstemmed | Associations of infection burden with Kawasaki disease in a population-based setting during 30 years |
| title_short | Associations of infection burden with Kawasaki disease in a population-based setting during 30 years |
| title_sort | associations of infection burden with kawasaki disease in a population based setting during 30 years |
| url | https://rmdopen.bmj.com/content/11/1/e005160.full |
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