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Filipino children at elevated risk for blood vessel inflammation associated with Kawasaki disease
Tremoulet AH. Pediatr Infect Dis J. 2011;doi:10.1097/INF.0b013e31821e52c6.
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Filipino children with Kawasaki disease are more likely to develop inflammation of the heart blood vessels than those of other Asian and non-Asian backgrounds, according to a study published online.
“Our call to action is for medical providers to have a heightened awareness of [Kawasaki disease] so patients can be treated promptly and the risk of heart disease is minimized,” Adriana H. Tremoulet, MD, assistant professor, department of pediatrics, University of California, San Diego School of Medicine, said in a press release about the study.
Tremoulet and colleagues analyzed 345 patients in San Diego Country who had Kawasaki disease. The researchers collected clinical and demographic data across three groups: Filipino, non-Filipino Asians and others.
Nearly 24% of Filipino children with Kawasaki disease in San Diego County were found to have aneurysms compared with 10.5% of children of other Asian descent (P=.016 and P=.021, respectively).
The researchers said their next steps are to increase awareness of Kawasaki disease in the Filipino community and to understand the genetic reasons why Filipino children are at higher risk of more severe Kawasaki disease.
Disclosure: Funding was provided in part by grants from the National Heart, Lung, and Blood Institute and the National Institute of Child Health and Human Development.
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Dr. Tremoulet and her colleagues in San Diego have highlighted an interesting finding that needs confirmation and, if confirmed, explanation. The number of Filipino children in this study is small (21 of 345 subjects), and the findings are of borderline statistical significance (P=.05 for dilation and/or aneurysms compared to non-Filipinos).
Increased rates of coronary aneurysms among children of Filipino ethnicity in San Diego with this complication could reflect a genetic susceptibility to a higher rate of this complication or diagnosis and treatment later in the course of illness, younger age at diagnosis or other factors. Genetic susceptibility markers for increased incidence of KD and/or for increased rates of coronary complications are being identified, and work in this area is ongoing, with particularly active research by the San Diego group.
-Stanford T. Shulman, MD
Infectious
Diseases in Children Editorial Board member
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