This study aimed to investigate the characteristics of febrile seizure (FS) associated with Kawasaki disease (KD) using nationwide population-based data. Children aged ≤ 5 years were analyzed using claims data from the Korean Health Insurance Review and Assessment Service between 2007 and 2022. FS and KD were identified using ICD-10 codes R56.0 and M30.3, respectively. Clinical characteristics were compared between FS associated with KD (KD-FS) and FS without KD (non-KD-FS). Of 1,230,434 children with FS, 1,683 (0.1%) had concomitant KD. Children with KD-FS were younger (1.66 vs. 1.81 years, p < 0.0001) and more likely to be male (58.8% vs. 55.9%, p = 0.0163) than those with non-KD-FS. During the coronavirus disease 2019 pandemic, the overall incidence of FS decreased markedly, whereas that of KD-FS increased. KD-FS occurred more frequently in winter and showed a distinct seasonal pattern, whereas the incidence of non-KD-FS peaked in summer. Children with KD-FS were more frequently treated in secondary or tertiary hospitals and had longer hospital stays. Chloral hydrate and acute/emergency anticonvulsants were more frequently administered in the KD-FS group; however, maintenance anticonvulsant use did not differ. Cerebrospinal fluid analysis and brain computed tomography were performed more frequently in the KD-FS group; brain magnetic resonance imaging and electroencephalography utilization and mortality rates were comparable.Conclusion: KD-FS is rare and does not appear to be associated with a more severe neurological course than non-KD-FS.<Table Float="No" ID="Taba"> <tgroup cols="1"> <colspec align="left" colname="c1" colnum="1" /> <tbody> <row> <entry align="left" colname="c1"> What is Known: • Kawasaki disease (KD) is a systemic vasculitis that can be accompanied by neurological manifestations, including febrile seizures (FS). • FS during acute KD is rare and remain insufficiently characterized in large population-based studies. </entry> </row> <row> <entry align="left" colname="c1"> What is New: • In this nationwide study, FS associated with KD are rare but show distinct demographic and seasonal features, including younger age and winter predominance. • However, FS associated with KD are not associated with worse neurological outcomes or mortality compared with non-KD febrile seizures. </entry> </row> </tbody> </tgroup> </Table> Graphical abstract

Febrile seizure during the acute phase of Kawasaki disease: a Korean nationwide cohort study

期刊论文
发表日期：

2026年7月27日

查看全文

Hee Joung Choi,
So Hyeon Gwon,
Nak-Hoon Son,
Jun Chul Byun

摘要

This study aimed to investigate the characteristics of febrile seizure (FS) associated with Kawasaki disease (KD) using nationwide population-based data. Children aged ≤ 5 years were analyzed using claims data from the Korean Health Insurance Review and Assessment Service between 2007 and 2022. FS and KD were identified using ICD-10 codes R56.0 and M30.3, respectively. Clinical characteristics were compared between FS associated with KD (KD-FS) and FS without KD (non-KD-FS). Of 1,230,434 children with FS, 1,683 (0.1%) had concomitant KD. Children with KD-FS were younger (1.66 vs. 1.81 years, p < 0.0001) and more likely to be male (58.8% vs. 55.9%, p = 0.0163) than those with non-KD-FS. During the coronavirus disease 2019 pandemic, the overall incidence of FS decreased markedly, whereas that of KD-FS increased. KD-FS occurred more frequently in winter and showed a distinct seasonal pattern, whereas the incidence of non-KD-FS peaked in summer. Children with KD-FS were more frequently treated in secondary or tertiary hospitals and had longer hospital stays. Chloral hydrate and acute/emergency anticonvulsants were more frequently administered in the KD-FS group; however, maintenance anticonvulsant use did not differ. Cerebrospinal fluid analysis and brain computed tomography were performed more frequently in the KD-FS group; brain magnetic resonance imaging and electroencephalography utilization and mortality rates were comparable.

Conclusion: KD-FS is rare and does not appear to be associated with a more severe neurological course than non-KD-FS.

What is Known:

• Kawasaki disease (KD) is a systemic vasculitis that can be accompanied by neurological manifestations, including febrile seizures (FS).

• FS during acute KD is rare and remain insufficiently characterized in large population-based studies.

What is New:

• In this nationwide study, FS associated with KD are rare but show distinct demographic and seasonal features, including younger age and winter predominance.

• However, FS associated with KD are not associated with worse neurological outcomes or mortality compared with non-KD febrile seizures.

Graphical abstract