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Rheumatology Advance Access published online on January 17, 2006
Rheumatology, doi:10.1093/rheumatology/kel007
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received April 18, 2005
Accepted December 8, 2005

Concise Report

Coeliac disease in patients with Kawasaki disease. Is there a link?

S. Stagi 1, G. Simonini 1, L. Ricci 1, M. de Martino 1, and F. Falcini 1 *

1 Department of Paediatrics, Paediatric Rheumatology Unit, University of Florence, Florence, Italy

* To whom correspondence should be addressed.
F. Falcini, E-mail: falcini{at}unifi.it


  Abstract

Objective. Kawasaki disease (KD) is an acute febrile systemic vasculitis, mainly affecting infants and young children. Immunological abnormalities during the acute phase of KD have been described extensively. However, the occurrence of a second immunological disorder in a patient with a history of KD is rarely reported. We evaluated the presence of autoimmune thyroiditis and coeliac disease (CD) in patients with KD diagnosis.

Methods. Ninety consecutive children (57 males and 33 females, median age 5.2 yr, age range 1.6-14.1 yr) with KD were evaluated. All patients were evaluated for thyroid function (thyroid-stimulating hormone, thyroxine and triiodothyronine), anti-thyroglobulin (TgA) and anti-peroxidase (TPOA) antibodies, and antigliadin, anti-endomysium and antitransglutaminase antibodies. CD was confirmed by jejunal biopsy if the specific antibody profile was positive. One hundred and fifty Italian children, matched for age and sex and from the same geographic area, acted as controls.

Results. A total of five patients (three boys, two girls; 5.5%; P<0.05) were found positive for coeliac antibodies. In all of these patients the diagnosis of CD was confirmed histologically. Regarding thyroid function and autoantibodies, no patient showed subclinical hypothyroidism or autoimmune thyroiditis. No differences in the familial occurrence of autoimmune diseases between KD patients and controls were found (9.1 and 7.9%, respectively).

Conclusions. Our data showed a higher prevalence of CD in children with KD, and this suggests that children with KD should be monitored carefully for CD. However, there was no increase in the prevalence of autoimmune thyroid diseases in patients with KD or the familial occurrence of autoimmune diseases.

Keywords: Kawasaki disease; Thyroid function; Thyroid autoantibodies; Coeliac disease; Vasculitis..
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