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Presentation and Outcomes of Kawasaki Disease in Latin American Infants Younger Than 6 Months of Age: A Multinational Multicenter Study of the REKAMLATINA Network

Objective: To characterize the clinical presentation and outcomes of Kawasaki disease (KD) in infants <6 months of age as compared to those ≥6 months in Latin America. Methods: We evaluated 36 infants <6 months old and 940 infants ≥6 months old diagnosed with KD in Latin America. We compared d...

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Autores principales: Moreno, Elizabeth, Garcia, S. Diana, Bainto, Emelia, Salgado, Andrea P., Parish, Austin, Rosellini, Benjamin D., Ulloa-Gutierrez, Rolando, Garrido-Garcia, Luis M., Dueñas, Lourdes, Estripeaut, Dora, Luciani, Kathia, Rodríguez-Quiroz, Francisco J., del Aguila, Olguita, Camacho-Moreno, Germán, Gómez, Virgen, Viviani, Tamara, Alvarez-Olmos, Martha I., de Souza Marques, Heloisa Helena, Faugier-Fuentes, Enrique, Saltigeral-Simental, Patricia, López-Medina, Eduardo, Miño-León, Greta, Beltrán, Sandra, Martínez-Medina, Lucila, Pirez, Maria C., Cofré, Fernanda, Tremoulet, Adriana H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378383/
https://www.ncbi.nlm.nih.gov/pubmed/32766186
http://dx.doi.org/10.3389/fped.2020.00384
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author Moreno, Elizabeth
Garcia, S. Diana
Bainto, Emelia
Salgado, Andrea P.
Parish, Austin
Rosellini, Benjamin D.
Ulloa-Gutierrez, Rolando
Garrido-Garcia, Luis M.
Dueñas, Lourdes
Estripeaut, Dora
Luciani, Kathia
Rodríguez-Quiroz, Francisco J.
del Aguila, Olguita
Camacho-Moreno, Germán
Gómez, Virgen
Viviani, Tamara
Alvarez-Olmos, Martha I.
de Souza Marques, Heloisa Helena
Faugier-Fuentes, Enrique
Saltigeral-Simental, Patricia
López-Medina, Eduardo
Miño-León, Greta
Beltrán, Sandra
Martínez-Medina, Lucila
Pirez, Maria C.
Cofré, Fernanda
Tremoulet, Adriana H.
author_facet Moreno, Elizabeth
Garcia, S. Diana
Bainto, Emelia
Salgado, Andrea P.
Parish, Austin
Rosellini, Benjamin D.
Ulloa-Gutierrez, Rolando
Garrido-Garcia, Luis M.
Dueñas, Lourdes
Estripeaut, Dora
Luciani, Kathia
Rodríguez-Quiroz, Francisco J.
del Aguila, Olguita
Camacho-Moreno, Germán
Gómez, Virgen
Viviani, Tamara
Alvarez-Olmos, Martha I.
de Souza Marques, Heloisa Helena
Faugier-Fuentes, Enrique
Saltigeral-Simental, Patricia
López-Medina, Eduardo
Miño-León, Greta
Beltrán, Sandra
Martínez-Medina, Lucila
Pirez, Maria C.
Cofré, Fernanda
Tremoulet, Adriana H.
author_sort Moreno, Elizabeth
collection PubMed
description Objective: To characterize the clinical presentation and outcomes of Kawasaki disease (KD) in infants <6 months of age as compared to those ≥6 months in Latin America. Methods: We evaluated 36 infants <6 months old and 940 infants ≥6 months old diagnosed with KD in Latin America. We compared differences in laboratory data, clinical presentation, treatment response, and coronary artery outcomes between the two cohorts. Results: The majority (78.1%) of infants and children ≥6 months of age were initially diagnosed with KD, as compared to only 38.2% of infants <6 months. Clinical features of KD were more commonly observed in the older cohort: oral changes (92 vs. 75%, P = 0.0023), extremity changes (74.6 vs. 57.1%, P = 0.029), and cervical lymphadenopathy (67.6 vs. 37.1%, P = 0.0004). Whether treated in the first 10 days of illness or after the 10th day, infants <6 months were at greater risk of developing a coronary artery aneurysm compared to KD patients ≥6 months treated at the same point in the course of illness [ ≤ 10 days (53.8 vs. 9.4%, P = 0.00012); >10 days (50 vs. 7.4%, P = 0.043)]. Conclusion: Our data show that despite treatment in the first 10 days of illness, infants <6 months of age in Latin America have a higher risk of developing a coronary artery aneurysm. Delay in the diagnosis leads to larger coronary artery aneurysms disproportionately in these infants. Thus, suspicion for KD should be high in this vulnerable population.
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spelling pubmed-73783832020-08-05 Presentation and Outcomes of Kawasaki Disease in Latin American Infants Younger Than 6 Months of Age: A Multinational Multicenter Study of the REKAMLATINA Network Moreno, Elizabeth Garcia, S. Diana Bainto, Emelia Salgado, Andrea P. Parish, Austin Rosellini, Benjamin D. Ulloa-Gutierrez, Rolando Garrido-Garcia, Luis M. Dueñas, Lourdes Estripeaut, Dora Luciani, Kathia Rodríguez-Quiroz, Francisco J. del Aguila, Olguita Camacho-Moreno, Germán Gómez, Virgen Viviani, Tamara Alvarez-Olmos, Martha I. de Souza Marques, Heloisa Helena Faugier-Fuentes, Enrique Saltigeral-Simental, Patricia López-Medina, Eduardo Miño-León, Greta Beltrán, Sandra Martínez-Medina, Lucila Pirez, Maria C. Cofré, Fernanda Tremoulet, Adriana H. Front Pediatr Pediatrics Objective: To characterize the clinical presentation and outcomes of Kawasaki disease (KD) in infants <6 months of age as compared to those ≥6 months in Latin America. Methods: We evaluated 36 infants <6 months old and 940 infants ≥6 months old diagnosed with KD in Latin America. We compared differences in laboratory data, clinical presentation, treatment response, and coronary artery outcomes between the two cohorts. Results: The majority (78.1%) of infants and children ≥6 months of age were initially diagnosed with KD, as compared to only 38.2% of infants <6 months. Clinical features of KD were more commonly observed in the older cohort: oral changes (92 vs. 75%, P = 0.0023), extremity changes (74.6 vs. 57.1%, P = 0.029), and cervical lymphadenopathy (67.6 vs. 37.1%, P = 0.0004). Whether treated in the first 10 days of illness or after the 10th day, infants <6 months were at greater risk of developing a coronary artery aneurysm compared to KD patients ≥6 months treated at the same point in the course of illness [ ≤ 10 days (53.8 vs. 9.4%, P = 0.00012); >10 days (50 vs. 7.4%, P = 0.043)]. Conclusion: Our data show that despite treatment in the first 10 days of illness, infants <6 months of age in Latin America have a higher risk of developing a coronary artery aneurysm. Delay in the diagnosis leads to larger coronary artery aneurysms disproportionately in these infants. Thus, suspicion for KD should be high in this vulnerable population. Frontiers Media S.A. 2020-07-16 /pmc/articles/PMC7378383/ /pubmed/32766186 http://dx.doi.org/10.3389/fped.2020.00384 Text en Copyright © 2020 Moreno, Garcia, Bainto, Salgado, Parish, Rosellini, Ulloa-Gutierrez, Garrido-Garcia, Dueñas, Estripeaut, Luciani, Rodríguez-Quiroz, del Aguila, Camacho-Moreno, Gómez, Viviani, Alvarez-Olmos, de Souza Marques, Faugier-Fuentes, Saltigeral-Simental, López-Medina, Miño-León, Beltrán, Martínez-Medina, Pirez, Cofré, Tremoulet and the REKAMLATINA-2 Study Group Investigators. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Moreno, Elizabeth
Garcia, S. Diana
Bainto, Emelia
Salgado, Andrea P.
Parish, Austin
Rosellini, Benjamin D.
Ulloa-Gutierrez, Rolando
Garrido-Garcia, Luis M.
Dueñas, Lourdes
Estripeaut, Dora
Luciani, Kathia
Rodríguez-Quiroz, Francisco J.
del Aguila, Olguita
Camacho-Moreno, Germán
Gómez, Virgen
Viviani, Tamara
Alvarez-Olmos, Martha I.
de Souza Marques, Heloisa Helena
Faugier-Fuentes, Enrique
Saltigeral-Simental, Patricia
López-Medina, Eduardo
Miño-León, Greta
Beltrán, Sandra
Martínez-Medina, Lucila
Pirez, Maria C.
Cofré, Fernanda
Tremoulet, Adriana H.
Presentation and Outcomes of Kawasaki Disease in Latin American Infants Younger Than 6 Months of Age: A Multinational Multicenter Study of the REKAMLATINA Network
title Presentation and Outcomes of Kawasaki Disease in Latin American Infants Younger Than 6 Months of Age: A Multinational Multicenter Study of the REKAMLATINA Network
title_full Presentation and Outcomes of Kawasaki Disease in Latin American Infants Younger Than 6 Months of Age: A Multinational Multicenter Study of the REKAMLATINA Network
title_fullStr Presentation and Outcomes of Kawasaki Disease in Latin American Infants Younger Than 6 Months of Age: A Multinational Multicenter Study of the REKAMLATINA Network
title_full_unstemmed Presentation and Outcomes of Kawasaki Disease in Latin American Infants Younger Than 6 Months of Age: A Multinational Multicenter Study of the REKAMLATINA Network
title_short Presentation and Outcomes of Kawasaki Disease in Latin American Infants Younger Than 6 Months of Age: A Multinational Multicenter Study of the REKAMLATINA Network
title_sort presentation and outcomes of kawasaki disease in latin american infants younger than 6 months of age: a multinational multicenter study of the rekamlatina network
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378383/
https://www.ncbi.nlm.nih.gov/pubmed/32766186
http://dx.doi.org/10.3389/fped.2020.00384
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