Who undertook this research?

This research was carried out by a team of doctors and researchers from the University of Nottingham, Nottingham University Hospitals NHS Trust, and the National Disease Registration Service at NHS Digital, as part of the RECORDER project (Registration of Complex Rare Diseases Exemplars in Rheumatology); and in collaboration with Prof. Paul Brogan, Professor of Vasculitis at University College London; and Rachael McCormack, Founder of Societi Foundation, the UK Foundation for Kawasaki Disease.

Why was this research undertaken?

Kawasaki disease causes fever that lasts at least 5 days, and possibly one or more of the following symptoms: a rash; swollen glands in the neck; dry, red cracked lips; a swollen, bumpy, red tongue; red inside the mouth and at the back of the throat; swollen and red hands and feet; red eyes. It can have serious, lifelong complications, particularly if it causes inflammation in the blood vessels around the heart resulting in bulges (coronary artery aneurysms). It mainly affects children under five years old, but about a quarter of children affected are older than 5. Correct diagnosis and treatment with a type of blood product (intravenous immunoglobulin) can help recovery and prevent heart problems.

Kawasaki disease is difficult to research. It is not clear how many people are diagnosed with it each year, or how many develop a heart problem. It is important to know the number of people affected by the disease, and who these people are, to be able to provide the specialised services & treatment needed.

How was the research undertaken?

The National Disease Registration Service collects information from National Health Service (NHS) records about people living with rare diseases in England and stores this securely on an electronic database. We used this database to search for information about patients admitted to hospital with a diagnosis of Kawasaki disease. We searched for data over a 15-year period (1 April 2006 - 31 March 2021). Having found a patient as having Kawasaki disease, we looked at their age, sex, ethnicity & socioeconomic status. We also looked to see whether they had developed a coronary artery aneurysm.

What did we find?

• We found 5908 children between the ages of 0 & 16 with a diagnosis of Kawasaki disease.
• Most were under five years old (4,387, 74.3%).
• One in every 12,500 children aged under 5 will be diagnosed with Kawasaki disease each year.
• Males are slightly more likely to get Kawasaki disease than females (3 males to 2 females).
• Kawasaki disease is more common in children in non-white ethnic groups.
• Kawasaki disease is more common in more deprived socioeconomic groups.
• The number of cases found didn’t change much from year to year.
• There were a higher number of cases in the winter months.
• We did not have enough information to calculate the overall risk of developing a coronary artery aneurysm. However, we found that 420 (7.1%) of the children we identified developed a coronary artery aneurysm within a few days of diagnosis. Other research has shown the overall total is much higher (c. 19%). The difference is because aneurysms usually take several weeks to develop.

How will these findings help us?

Our findings will help with planning services and treatment for patients diagnosed with Kawasaki disease. They may also help to identify future areas of research to help identify possible causes of the disease and potential treatments.

Full paper published in Rheumatology or scan the QR code 

 

Reference: Myron Odingo, Megan Rutter, Jonathan Bowley, Emily J Peach, Peter C Lanyon, Matthew J Grainge, Peter Stillwell, Sean McPhail, Mary Bythell, Jeanette Aston, Sarah Stevens, Rachael McCormack, Paul Brogan, Fiona A Pearce, The incidence of Kawasaki disease using hospital admissions data for England 2006-2021, Rheumatology, 2023;, kead051, https://doi.org/10.1093/rheumatology/kead051