Association between Kawasaki disease and autism: a population-based study in Taiwan.
OBJECTIVE
The association between Kawasaki disease and autism has rarely been studied in Asian populations. By using a nationwide Taiwanese population-based claims database, we tested the hypothesis that Kawasaki disease may increase the risk of autism in Taiwan.


METHODS
Our study cohort consisted of patients who had received the diagnosis of Kawasaki disease (ICD-9-CM: 446.1) between 1997 and 2005 (N = 563). For a comparison cohort, five age- and gender-matched control patients for every patient in the study cohort were selected using random sampling (N = 2,815). All subjects were tracked for 5 years from the date of cohort entry to identify whether they had developed autism (ICD-9-CM code 299.0) or not. Cox proportional hazard regressions were then performed to evaluate 5-year autism-free survival rates.


RESULTS
The main finding of this study was that patients with Kawasaki disease seem to not be at increased risk of developing autism. Of the total patients, four patients developed autism during the 5-year follow-up period, among whom two were Kawasaki disease patients and two were in the comparison cohort. Further, the adjusted hazard ratios (AHR) (AHR: 4.81; 95% confidence interval: 0.68-34.35; P = 0.117) did not show any statistical significance between the Kawasaki disease group and the control group during the 5-year follow-up.


CONCLUSIONS
Our study indicated that patients with Kawasaki disease are not at increased risk of autism.
Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan. erickuo48@yahoo.com.tw.
Ho-Chang
HC
Kuo
Department of Business Management, National Taipei University of Technology, Taipei 106, Taiwan. cmwu@ntut.edu.tw.
Chung-Min
CM
Wu
Department of Healthcare Management, Yuanpei University, HsinChu 300, Taiwan. wpchang@mail.ypu.edu.tw.
Wei-Pin
WP
Chang
Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan. rencouter@gmail.com.
Chun-Nan
CN
Kuo
Shawnee, Kansas, 66226, USA. deniz.yeter@gmx.de.
Deniz
D
Yeter
Department of Healthcare Management, Yuanpei University, HsinChu 300, Taiwan. elaine_lin76@ymail.com.
Chun-Yi
CY
Lin
Department of Healthcare Management, Yuanpei University, HsinChu 300, Taiwan. reitrong@mail.ypu.edu.tw.
Jei-Tsung
JT
Pai
Department of Education & Research, Taipei City Hospital, Taipei 106, Taiwan. a0130@tpech.gov.tw.
Ying-Chen
YC
Chi
Department of Health Industry Management, School of Health Care Management, Kainan University, Taoyuan 338, Taiwan. g870615@gmail.com.
Chia-Hsien
CH
Lin
Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan. wangliangjen@gmail.com.
Liang-Jen
LJ
Wang
Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan. rencouter@gmail.com.
Wei-Chiao
WC
Chang
D001321:Autistic Disorder / Q000453:epidemiology*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000453:epidemiology*; D015995:Prevalence; D012306:Risk; D013624:Taiwan / Q000453:epidemiology