title: Hospitalisation with infection, asthma and allergy in Kawasaki disease patients and their families: genealogical analysis using linked population data.
abstract: BACKGROUND
  Kawasaki disease results from an abnormal immunological response to one or more infectious triggers. We hypothesised that heritable differences in immune responses in Kawasaki disease-affected children and their families would result in different epidemiological patterns of other immune-related conditions. We investigated whether hospitalisation for infection and asthma/allergy were different in Kawasaki disease-affected children and their relatives.
  We used Western Australian population-linked health data from live births (1970-2006) to compare patterns of hospital admissions in Kawasaki disease cases, age- and sex-matched controls, and their relatives. There were 295 Kawasaki disease cases and 598 age- and sex-matched controls, with 1,636 and 3,780 relatives, respectively. Compared to controls, cases were more likely to have been admitted at least once with an infection (cases, 150 admissions (50.8%) vs controls, 210 admissions (35.1%); odds ratio (OR) = 1.9, 95% confidence interval (CI) 1.4-2.6, P = 7.2×10⁻⁶), and with asthma/allergy (cases, 49 admissions (16.6%) vs controls, 42 admissions (7.0%); OR = 2.6, 95% CI 1.7-4.2, P = 1.3×10⁻⁵). Cases also had more admissions per person with infection (cases, median 2 admissions, 95% CI 1-5, vs controls, median 1 admission, 95% CI 1-4, P = 1.09×10⁻⁵). The risk of admission with infection was higher in the first degree relatives of Kawasaki disease cases compared to those of controls, but the differences were not significant.
  
  
  CONCLUSIONS
  Differences in the immune phenotype of children who develop Kawasaki disease may influence the severity of other immune-related conditions, with some similar patterns observed in relatives. These data suggest the influence of shared heritable factors in these families.
authors.affiliation: Centre for Genetic Epidemiology and Biostatistics, University of Western Australia, Perth, Australia.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Webster
authors.forename: Kim W
authors.initials: KW
authors.lastname: Carter
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Warrington
authors.forename: Angeline M
authors.initials: AM
authors.lastname: Loh
authors.forename: Sophie
authors.initials: S
authors.lastname: Zaloumis
authors.forename: Taco W
authors.initials: TW
authors.lastname: Kuijpers
authors.forename: Lyle J
authors.initials: LJ
authors.lastname: Palmer
authors.forename: David P
authors.initials: DP
authors.lastname: Burgner
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D001249:Asthma / Q000150:complications* / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000150:complications* / Q000453:epidemiology; D019992:Databases as Topic / Q000706:statistics & numerical data*; D005190:Family; D005260:Female; D005789:Genealogy and Heraldry; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000453:epidemiology; D011634:Public Health / Q000706:statistics & numerical data*; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult