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Seasonality in clinical courses of Kawasaki disease
  1. Daisuke Shimizu1,
  2. Takayuki Hoshina1,
  3. Masaru Kawamura1,2,
  4. Yoshie Tomita3,
  5. Yasufumi Hidaka4,
  6. Masumi Kojiro5,
  7. Jun Muneuchi6,
  8. Junji Kamizono3,
  9. Kenichiro Yamaguchi2,
  10. Yoshihisa Fujino7,
  11. Koichi Kusuhara1
  1. 1Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
  2. 2Department of Pediatrics, National Hospital Organization Kokura Medical Center, Kitakyushu, Japan
  3. 3Department of Pediatrics, Kitakyushu Municipal Yahata Hospital, Kitakyushu, Japan
  4. 4Department of Pediatrics, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
  5. 5Department of Pediatrics, Kitakyushu General Hospital, Kitakyushu, Japan
  6. 6Department of Pediatrics, Japan Community Health Care Organization Kyushu Hospital, Kitakyushu, Japan
  7. 7Department of Environmental Epidemiology, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
  1. Correspondence to Dr Takayuki Hoshina, Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu , Japan; hoshina{at}med.uoeh-u.ac.jp

Abstract

Objective Epidemics of Kawasaki disease (KD) are well known; however, the seasonal variation in the clinical course of KD is uncertain. The aim of this study was to investigate the seasonality in the clinical course of KD.

Methods This study included 744 patients who were admitted to six hospitals in Kitakyushu City for KD from 2010 to 2014. We divided the patients into two groups according to the average monthly temperature (warm and cold periods) and compared the clinical courses of KD.

Results The clinical courses of 715 patients who were initially treated with intravenous immunoglobulin (IVIG) were investigated. The proportion of patients with resistance to the initial IVIG therapy was significantly higher during the warm period than during the cold period (p=0.016). There was no seasonality in the proportion of patients with coronary artery abnormalities.

Conclusion Seasonality was observed in the response to IVIG therapy of patients with KD.

  • Kawasaki disease
  • seasonality
  • refractory to high-dose intravenous immunoglobulin therapy
  • coronary artery abnormality

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Footnotes

  • DS and TH contributed equally.

  • Contributors DS conceptualised the study, carried out the initial analysis of data for work, drafted the initial manuscript, approved the final version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. TH designed the study, carried out the acquisition and analysis of data for the work, revised the work critically for important intellectual content, approved the final version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MK, YT, YH, MK, JM, JK, KY and YF carried out the acquisition and analysis of data for the work, revised the work critically for important intellectual content, approved the final version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. KK designed the study, carried out the analysis and interpretation of data for the work, revised the work critically for important intellectual content, approved the final version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. DS and TH wrote the first draft of the manuscript. Honorarium, grant and other form of payment were not given to anyone to produce the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The Institutional Review Board of the University of Occupational and Environmental Health, Japan.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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