Diagnosis of systemic-onset juvenile idiopathic arthritis after treatment for presumed Kawasaki disease.

Abstract

OBJECTIVES:

To estimate the incidence of systemic-onset juvenile idiopathic arthritis (SoJIA) within 6 months after treatment for presumed Kawasaki disease (KD) (presumed patients with KD with subsequent diagnosis of SoJIA [pKD/SoJIA]) and describe presentation differences from sole KD.

STUDY DESIGN:

We identified patients treated for KD at Nationwide Children's Hospital and from the Pediatric Health Information System from 2009-2013. We then identified the subset of children, pKD/SoJIA, who received an International Classification of Diseases, Ninth Revision code for SoJIA and had it listed at least once 3 months after and within 6 months after KD diagnosis. Demographic characteristics, readmission rates, treatments, and complications were noted. A literature review was also performed to identify clinical, laboratory, and echocardiographic data of previously documented patients with KD later diagnosed with SoJIA.

RESULTS:

There were 6745 total treated patients with KD in the Pediatric Health Information System database during the study period; 10 patients were identified to have pKD/SoJIA (0.2% of cohort). Those with pKD/SoJIA were predominantly Caucasian compared with patients with KD (90% and 46.8%, respectively; P=.003). Macrophage activation syndrome was more common in patients with pKD/SoJIA than in sole patients with KD (30% and 0.30%, respectively; P<.001). Fifteen cases of pKD/SoJIA were identified by literature and chart review, 12 of whom were initially diagnosed with incomplete KD.

CONCLUSIONS:

We reported a 0.2% incidence of pKD/SoJIA, which was associated with Caucasian race, macrophage activation syndrome, and an incomplete KD phenotype.

• Authors: Siwen Dong, Sharon Bout-Tabaku, Karen Texter, Preeti Jaggi
• Journal: The Journal of pediatrics (J Pediatr) Vol. 166 Issue 5 Pg. 1283-8 (May 2015) ISSN: 1097-6833 [Electronic] United States
• PMID: 25771391 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Topics

• Arthritis, Juvenile (complications, diagnosis, epidemiology)
• Child, Preschool
• Comorbidity
• Databases, Factual
• Female
• Fever
• Hospitals, Pediatric
• Humans
• Incidence
• Infant
• Macrophage Activation Syndrome (complications, diagnosis, epidemiology)
• Male
• Mucocutaneous Lymph Node Syndrome (complications, diagnosis, epidemiology)
• Patient Readmission
• Phenotype
• Retrospective Studies