Over 20 years of follow-up, Kawasaki disease was associated with sustained increased risk of psoriasis and a significant rise in vitiligo risk at 10 years, supporting 'selective long-term immune dysregulation following KD' rather than generalized autoimmune susceptibility.
Kawasaki disease was associated with a significantly increased risk of psoriasis from 2 years through 15 years of follow-up, attenuating to non-significance at 20 years.
Vitiligo risk in children with Kawasaki disease reached statistical significance at the 10-year follow-up mark.
A nominally significant elevation in Hodgkin lymphoma (HL) risk was observed from 15 years onward, but was based on very few events and characterized as an exploratory signal only.
No significant associations were found between Kawasaki disease and hypothyroidism, type 1 diabetes mellitus, immune thrombocytopenia, celiac disease, inflammatory bowel disease, or non-Hodgkin lymphoma.
The study used a large retrospective matched cohort design with 2,126 children with Kawasaki disease matched 1:5 to 10,630 controls followed for up to 20 years.
This research suggests that children who had Kawasaki disease — a condition causing blood vessel inflammation — face a higher long-term risk of developing certain immune-related skin conditions compared to children who did not have the disease. Specifically, the study found that the risk of psoriasis (a chronic skin condition) was elevated for up to 15 years after Kawasaki disease, and the risk of vitiligo (a condition causing loss of skin pigmentation) became significantly elevated by 10 years after the illness. These findings come from tracking over 2,100 children with Kawasaki disease and more than 10,000 matched comparison children for up to 20 years using a large Israeli health database. Importantly, the study also found that many other autoimmune conditions — including type 1 diabetes, thyroid disease, celiac disease, inflammatory bowel disease, and immune-related low platelet counts — were not significantly more common in children with Kawasaki disease. This suggests the immune disruption caused by Kawasaki disease is selective rather than broadly increasing the risk of all autoimmune diseases. There was also a statistical signal suggesting a possible increased risk of Hodgkin lymphoma in the long term, but this was based on very few cases and the authors caution strongly that this finding requires further investigation before conclusions can be drawn. This research suggests that children who have had Kawasaki disease may benefit from ongoing awareness of skin-related autoimmune conditions during long-term follow-up care. The findings add to growing evidence that the immune changes triggered by Kawasaki disease can have lasting effects beyond the initial illness, potentially influencing healthcare monitoring strategies for this population over many years.
Kasem Ali Sliman R, Shalaby N, Cohen H, Hadar D, Halabi I, Hamad Saied M. (2026). Autoimmune and lymphoproliferative outcomes after Kawasaki disease: a 20-year population-based cohort study.. European journal of pediatrics. https://doi.org/10.1007/s00431-026-07356-w