Kawasaki Disease: Is it Blowin’ in the Wind?

Friday, April 19, 2019 -
2:00pm to 3:00pm
The FUNG Auditorium
Jane C. Burns

Professor and Director, Kawasaki Disease Research Center

Dept. of Pediatrics

University of California San Diego

 

Kawasaki Disease: Is it Blowin’ in the Wind?

Abstract: 

Kawasaki disease (KD) is the most common acquired heart disease in children. Untreated, roughly one-quarter of children with KD develop coronary artery aneurysms — balloon-like bulges of heart vessels — that may ultimately result in heart attacks, congestive heart failure or sudden death. The cause of KD is one of the great mysteries in contemporary medicine. Although KD is estimated to affect fewer than 6,000 children in the U.S. each year, the incidence is rising in San Diego County. While the average incidence per 100,000 children less than 5 years of age residing in San Diego County was approximately 10 for the decade of the 1990s, the estimate from 2006–2015 was 25.5. This may be through the efforts of the KD Team at Rady Children’s Hospital to teach local physicians how to diagnose KD. Or it may be due to increasing exposure to the environmental triggers of the disease. Incidence rates of KD are increasing among children in Asia. Japan has the highest incidence rate, with more than 16,000 new cases per year. One in every 60 boys and one in every 75 girls in Japan will develop KD during childhood. Incidence rates in the U.S. are approximately 19 to 25 cases per 100,000 children under age 5 — but are higher in children of Asian descent. Predictive models estimate that by 2030, 1 in every 1,600 American adults will have been affected by the disease.

The UCSD team examined 1164 cases of KD treated at Rady Children’s Hospital over 15 years. Noticeable clusters of KD cases were often associated with distinct atmospheric patterns that are suspected to transport or concentrate agents that result in KD.    Days preceding and during the KD clusters exhibited higher than average atmospheric pressure and warmer conditions in Southern California along with a high pressure feature south of the Aleutian Islands.  Gene expression analysis further revealed distinct groups of KD patients based on their gene expression pattern, and that the different groups were associated with certain clinical characteristics.

These data suggest that one or more environmental triggers exist, and that episodic exposures are influenced at least in part by regional weather conditions. We propose that characterization of the environmental factors that trigger KD in genetically susceptible children should focus on aerosols inhaled by patients who share common disease characteristics.

 

 

Bio: 

Dr. Jane C. Burns is a native of San Francisco, California. She received her M.D. degree at the University of North Carolina in Chapel Hill in 1978 and completed her pediatric residency and Chief Residency at the University of Colorado School of Medicine in Denver, Colorado. In 1983, Dr. Burns moved to Boston Children’s Hospital for additional training in pediatric infectious diseases and molecular virology. She joined the faculty at Harvard in 1986 and in 1990 moved to San Diego where she joined the faculty at the University of California. Dr. Burns moved up through the ranks and was appointed Professor of Pediatrics in 1999.

Currently, Dr. Burns is Director of the Kawasaki Disease Research Center at UCSD/Rady Children’s Hospital where she leads a multidisciplinary team that cares for 80-100 new Kawasaki disease patients each year. She also serves as Chair of the Pediatric IRB Committee.

Her passion for studies of Kawasaki disease has spanned more than three decades with her first publication on KD in 1982. In addition to her academic pursuits, Dr. Burns is the mother of two daughters. Her husband, John B. Gordon M.D., is an interventional cardiologist who cares for adults with long-term sequelae of KD.