Name: Cardo Dalisay Date: 09/05/2023

Section: BSA 3A

Epidemiology
Rates of recurrence and familial occurrence of KD are best documented in
literature from Japan; recurrence rates could be lower in other races and
ethnicities. In Japan, the recurrence rate of KD has been reported to be ≈3%
in one study,22 and in a review of 4560 patients, it was noted to be 5.21
episodes per 1000 patient-years of follow-up, highest in the first 2 years after
the index episode.23 From the nationwide surveys in Japan, the recurrence
rate was reported to be 6.89 episodes per 1000 patient-years of follow-
up.24 A comparison of surveillance data from the United States (1984–2008)
and Japan (2001–2002) showed a rate of 1.7% in the United States, which
increased to 3.5% in Asians and Pacific Islanders, which was similar to the
rate of 3.5% in Japan.25 In Canada, a review of 1010 patients showed a
recurrence rate of 2.9 episodes per 1000 patient-years of follow-up, with
recurrences occurring at a median of 1.5 years after the index episode and
with similar features and outcomes.26 However, Nakamura et al27 reported a
higher risk of developing coronary artery sequelae with the recurrent
episode, regardless of the sequelae developed with the index episode. The
proportion of cases with a positive family history is ≈1%.22,24 Within 1 year
after the onset of the first case in a family, the rate in a sibling is 2.1%, a
relative risk of ≈10-fold compared with the Japanese population in general;
approximately half of the second cases develop within 10 days of the first
case.28 The risk of concordance in identical twins is ≈13%.28–30 Higher rates of
KD in siblings of index cases and twins are consistent with a genetic
predisposition that interacts with exposure to the pathogenic agent or
agents in the environment.28,29,31,32 The reported occurrence of KD in children
of parents who themselves had the illness in childhood also supports the
contribution of genetic factors.33–3