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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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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. |
format | Online Article Text |
id | pubmed-7378383 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
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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