Kawasaki Disease and Atopic Diseases: A Systematic Review and Meta-Analysis of Observational Studies

Abstract

Introduction: The etiology of Kawasaki disease (KD), an inflammatory and cardiovascular disorder, remains largely unexplained after more than 50 years of intensive research. In recent years, the association between KD and atopic diseases had been explored by some observational studies. We systematically reviewed and summarized the literature on the relationship between KD and atopic diseases. Methods: MEDLINE and EMBASE were searched to identify observational studies on the association between KD and atopic diseases from inception to May 2021. Odds ratio (OR) was pooled using random-effects models. Heterogeneity was assessed using the I² and Cochran Q statistics. Primary outcomes were to compare the prevalence of KD among individuals with atopic diseases to nonatopic disease controls and the prevalence of atopic diseases among individuals with KD to non-KD controls. Results: Thirteen studies, including 12,651 cases and 170,708 controls, were included in this meta-analysis. In cross-sectional studies, KD was associated with allergic rhinitis (n = 6; OR, 1.69; 95% CI, 1.52–1.87), asthma (n = 3; OR, 1.72; 95% CI, 1.38–2.14), allergic conjunctivitis (n = 2; OR, 1.95; 95% CI, 1.68–2.27), and atopic dermatitis (n = 3; OR, 1.35; 95% CI, 1.22–1.49). In case-control and cohort studies, KD was associated with allergic rhinitis (n = 3; OR, 1.35; 95% CI, 1.28–1.43), asthma (n = 8; OR, 1.40; 95% CI, 1.19–1.65), allergic conjunctivitis (n = 1; OR, 1.74; 95% CI, 1.45–2.09), and atopic dermatitis (n = 3; OR, 1.39; 95% CI, 1.26–1.53). Conclusion: KD diagnosed was associated with four common atopic diseases. Among the four allergic diseases, allergic conjunctivitis and asthma have the highest correlation with KD, which may provide a direction for exploring the etiology of KD.