Fil Am Children At Higher Risk of Kawasaki Disease

By JOSEPH G. LARIOSA

(© 2011 Journal Group Link International)

CHICAGO (jGLi) -- Filipino children in San Diego, California are found to be at higher risk to contract Kawasaki Disease, a heart disease that causes sudden death among children, than non-Filipinos.

While children of all ethnicities can contract Kawasaki disease (KD), a study led by researchers at the Kawasaki Disease Research Center at the University of California, San Diego and Rady Children’s Hospital-San Diego finds that Filipino children with KD are at a higher risk for inflammation of the blood vessels of the heart than those of other Asian and non-Asian backgrounds. 

Nearly 24 percent of Filipino children with KD in San Diego County were found to have aneurysms compared to 10.5 percent of children of other Asian descent, according to information circulated by Michelle Brubaker and Maria Rosario (Happy) Araneta, Ph. D., associate professor of the Department of Family and Preventive Medicine of the University of California, San Diego, who were requested by study authors, Drs. Andriana H. Tremoulet and Susan Jimenez-Fernandez, to disseminate the information.

The study appeared in the May 6, 2011 issue of Pediatric Infectious Disease Journal.

While KD incidence was highest among children of Japanese descent at 219 per 100,000 children aged below five years old, incidence of KD among Asian descent in San Diego county was previously shown to be 2.7 times higher compared with non-Asian children.

“Filipinos make up the largest Asian subgroup in San Diego County, yet there are no available reports of KD in Filipino children,” said Adriana H. Tremoulet, MD, MAS, assistant professor, Department of Pediatrics, UC San Diego School of Medicine. 

“With the results of this study, our call to action is for medical providers to have a heightened awareness of KD, so patients can be treated promptly and the risk of heart disease is minimized.  Parents, especially those of Filipino descent, need to know the signs and symptoms of KD and when to contact their physician.”

Clinical signs of KD include fever, rash, red eyes, swollen glands in the neck, swollen and red hands and feet, and red, cracked lips. If left untreated, one in four children will develop permanent damage to their blood vessels and heart.

The team analyzed 345 patients in San Diego Country who had KD.  They collected clinical and demographic data, across three groups – Filipino, non-Filipino Asians and others.

“Our findings indicate there may be genetic reasons why there is a higher attack rate of KD and aneurysms in Filipino children,” said Tremoulet.  “Our next steps are to increase awareness of KD in the Filipino community and to understand the genetic reasons why Filipino children are at higher risk of more severe KD.”

In addition to Tremoulet, the research team includes Gemmie Devera, MS, MPH, Brookie M. Best, PharmD, MAS, Skaggs School of Pharmacy and Pharmaceutical Sciences; Susan Jimenez-Fernandez, MD, Department of Pediatrics; Xiaoying Sun, MS, Department of Family and Preventive Medicine; Sonia Jain, PhD, Department of Family and Preventive Medicine; and Jane C. Burns, MD, Department of Pediatrics.

Funding for the study was provided in part by grants from the National Heart, Lung and Blood Institution, and the National Institute of Child Health and Human Development.

Kawasaki disease was first noticed in Japan after World War II. Two decades later while working at the Tokyo Red Cross Medical Centre in Japan, Tomisaku Kawasaki noticed in about 50 children from 1961-1967 who presented with a distinctive clinical illness characterized by fever and rash, which was then thought to be a benign childhood illness.

There were sudden deaths reported in children less than 2 yrs of age, who had recovered or were in the process of recovery. Post-mortem reports found that death was caused due to serious complications involving the heart, causing large thrombosis and MI (myocardial infarction). Kawasaki disease is now recognized worldwide. While it is more common among the Japanese, it is now known to occur in all racial groups, primarily in children under than 5 years of age.  (lariosa_jos@sbcglobal.net)