Rates of Juvenile Idiopathic Arthritis Elevated Among Children With Kawasaki Disease

Kawasaki disease (KD) was found to be associated with increased juvenile idiopathic arthritis (JIA) risk, according to the results of a population-based cohort study published in Frontiers in Immunology.

Arthritis is common among patients with KD, occurring at a rate of 30% in this population. Despite the known association between KD and arthritis, little is known about the association between KD and risk for JIA.

To understand the association between KD and JIA, researchers from Chung Shan Medical University Hospital in Taiwan collected data from Taiwan’s National Health Insurance Research Database (NHIRD), which includes data from more than 99% of the country’s population.

Children who received a new KD diagnosis between 2010 and 2018 were evaluated on the basis of hospitalization or outpatient care for JIA. A group of non-KD patients were matched for age, sex, geographic, and comorbidity.

The KD and control cohorts included children aged 2.12±2.26 years and 2.44±2.15 years, respectively; 59.88% were girls in each group.

A total of 14 and 51 new JIA cases were documented during follow-up, at rates of 0.39 and 0.18 per 10,000 person-months in the KD and non-KD groups, respectively.

Incidence of JIA was associated with KD, after adjusting for cofounders (adjusted hazard ratio [aHR], 2.02; 95% CI, 1.12-3.67; P =.0205).

Other predictors for JIA included allergic rhinitis (aHR, 3.06; 95% CI, 1.60-5.84; P =.0007) and age 6 to 18 years compared with age 0 to 3 years (aHR, 2.82; 95% CI, 1.49-5.34; P =.0015).

In subgroup analyses, risk for JIA was significantly higher among girls with KD (aHR, 3.01; 95% CI, 1.38-6.54; P =.0054) and children with KD without allergic rhinitis vs control participants (aHR, 2.31; 95% CI, 1.18-4.51; P =.0144).

Study limitations included that the findings may not be generalizable to patients with mild symptoms who did not seek medical care.

The study authors concluded, “Children with KD were at a 2.02-fold higher JIA risk than children without KD, regardless of sex, level of urbanization, age, or comorbidities. Therefore, when caring for a child with KD, the clinician should be aware of the possibility that other systemic inflammatory disorders, such as JIA, can develop in the future.”