ASSOCIATION OF KAWASAKI SYNDROME WITH ATOPIC DERMATITIS

Abstract

Atopic dermatitis (AD) is associated with immunoregulatory abnormalities similar to those observed in acute Kawasaki Syndrome (KS) as well as with increased susceptibility to viral infections. We investigated whether the prevalence of AD is increased among children who acquire KS. In a case-control telephone survey, 83 KS patients and 83 controls with innocent heart murmur were matched for age and time period between clinic visit and interview. The nurse-interviewer was blinded to the study's hypothesis. Cases and controls were similar in socioeconomic status, racial distribution, and number of winters in New England. Atopic dermatitis was defined as a chronic eczematoid dermatitis (separate from rash of KS) associated with personal or family history of inhalant allergy. Nine (11%) KS patients but only 1 (1%) control patient had AD; the odds of AD was 9 times greater in KS than in control patients (p <.01, Mantel-Haenszel). Serum IgE levels were significantly higher (p <.02, Mann-Whitney) in 44 unselected KS patients (median 22, range <4 to 900 IU/ml) studied 6 to 12 months after onset than in 27 controls (median <4, range <4 to 164 IU/ml). We conclude that children who acquire KS are significantly more likely than matched controls to have atopic dermatitis.