It is well known that Kawasaki disease has racial and ethnic variations in prevalence, response to intravenous gamma globulin, and outcomes. However, relatively little is known about African American children. In this volume of The Journal, Padilla et al report on comparisons between African American and white children with respect to Kawasaki Disease outcomes. They found that African American children were more likely to be refractory to IVIG treatment, have more severe inflammation, and had a greater proportion of persistent coronary artery abnormalities at follow-up compared with white children.
One important issue in understanding this comparison is whether there are health system disparities that could account for the observed differences between African American and white children. Padilla et al found no difference related to time to admission to the hospital or IVIG treatment compared to disease onset. There was also no significant difference in coronary artery abnormality at the time of admission. These finding suggest that the health care system disparities are not the likely explanation for the findings.
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