Children with Kawasaki disease are 29 X more likely to be Vitamin D deficient – Jan 2022

The impact of vitamin D on the onset and progress of Kawasaki disease

Pediatr Int. 2022 Jan;64(1):e15191. doi: 10.1111/ped.15191 PDF is behind a $10 paywall
Natsumi Okazaki 1, Hiroyuki Ikeda 1, Takafumi Honda 2, Kazuma Tsuno 1, Fumiya Inoue 1, Satoko Takahashi 1, Ayako Sakurai 1, Hideaki Ueki 1, Yasushi Noguchi 1, Hiromichi Hamada 3, Shunji Igarashi 1

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Background: The seasonal epidemic of Kawasaki disease (KD) in winter in Japan suggests that low vitamin D status may affect KD through the immune system. We aimed to evaluate the effect of vitamin D on the onset and clinical course of KD.

Methods: We conducted a case-control study to compare 25-hydroxyvitamin D (25(OH)D) levels in KD patients admitted to our hospital between March 2018 and June 2021, with those in healthy controls from published Japanese data. In patients with KD, we evaluated the association of 25(OH)D levels with intravenous immunoglobulin resistance and coronary artery lesions.

Results: We compared 290 controls and 86 age-group-adjusted patients with KD. The 25(OH)D levels in KD patients were lower than those in the controls (median: 17 vs. 29 ng/mL, P < 0.001). In winter, 25(OH)D levels in KD patients were lower than those in summer (median: 13 vs. 19 ng/mL). The adjusted odds ratios for the onset of KD were 4.9 (95% CI: 2.5-9.6) for vitamin D insufficiency (25(OH)D: 12-20 ng/mL) and 29.4 (95% CI: 12.5-78.2) for vitamin D deficiency (25(OH)D < 12 ng/mL). Among 110 KD patients, 25(OH)D levels at diagnosis of KD were not associated with intravenous immunoglobulin resistance or coronary artery lesions.

Conclusions: The 25(OH)D levels in patients with KD were lower than those in the controls, especially in winter. Lower 25(OH)D levels in winter were associated with an increased risk of KD onset. It remains to be elucidated whether the observed association has a causal relationship.

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