All issues > Volume 52(11); 2009

Original Article

Korean J Pediatr. 2009;52(11):1241-1248. Published online November 15, 2009.

Association between Kawasaki disease and acute respiratory viral infections

Eun Young EY Cho¹, Byung Wook BW Eun², Nam Hee NH Kim³, Jina Jn Lee¹, Eun Hwa EH Choi¹, Hoan Jong HJ Lee¹, Jung Yun JY Choi¹

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
²Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science, Incheon, Korea,
³Department of Pediatrics, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea

Correspondence Eun Hwa EH Choi ,Email: eunchoi@snu.ac.kr

Abstract

Purpose
: The etiology of Kawasaki disease (KD) is still unknown. Recently, an association between human coronavirus NL63 (HCoV-NL63) and KD was implicated. Hence, we attempted to determine the association between KD and acute respiratory viral infections.
Methods
: Nasopharyngeal aspirate samples were obtained from 54 patients diagnosed with KD at the Seoul National University (SNU) Children’s Hospital and SNU-Bundang Hospital between October 2003 and September 2006. Viral diagnoses of 11 respiratory viruses were made using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR): respiratory syncytial virus (RSV), adenovirus, rhinovirus (RV), parainfluenza viruses (PIVs) 1 and 3, influenza viruses (IFVs) A and B, human metapneumovirus (HMPV), human bocavirus (HBoV), HCoV OC43/229E, and HCoV-NL63. Clinical data were reviewed retrospectively.
Results
: The median age was 32 months (6 months-10.4 years). Respiratory symptoms were observed in 37 patients (69%). The following respiratory viruses were identified in 12 patients (22%): RV (n=4), PIV-3 (n=2), HBoV (n=2), and adenovirus, RSV, PIV-1, IFV-A, and HCoV-NL63 (n=1). Co-infection with PIV-3 and RV was observed in one patient. Respiratory symptoms were observed in 7 (58.3%) and 30 (71.4%) patients of the virus-positive and virus-negative groups (P> 0.05). Response rate to intravenous immunoglobulin administration was 67% (n=8) and 86% (n=36) in the virus- positive and virus-negative groups (P>0.05).
Conclusion
: Respiratory symptoms were commonly observed in KD patients but the association between respiratory viruses and KD were not found. Large multicenter-based investigations are required to confirm the association between acute respiratory viral infections and KD.

Keywords :Kawasaki disease, Respiratory tract infections, Human coronavirus