In spite of many reports of recurrent Kawasaki disease, little information about the risk factors associated with recurrence is available. We conducted a case-control study on 150 cases of recurrent Kawasaki disease and 1173 pair-matched controls selected from the database of nationwide surveys of the same disease in Japan. Items observed were: sex, age, use of intravenous gamma globulin, and cardiac sequelae at the first episode. Sex and cardiac sequelae did not affect the risk of recurrence. One- to 2-year-old children were more likely to be affected again than infants (odds ratio [OR] = 1.42; 95% confidence interval [CI], 0.94-2.13), and children who were 3 years of age or older were less likely to experience a recurrence than infants (OR = 0.59; 95% CI, 0.34-1.02). Intravenous gamma globulin therapy at the first episode increased the risk for recurrence of Kawasaki disease within 12 months (OR = 2.66, 95% CI, 1.06-6.66). However, it did not affect recurrences 12 months after the first episode (OR = 1.02; 95% CI, 0.53-1.97).
Conclusion: Patients with Kawasaki disease treated with intravenous gamma globulin are 2.66 times as likely to be affected by the disease again within 12 months as those treated without intravenous gamma globulin.