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 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.

• Autores: Moreno, Elizabeth; García, Sara Diana; Bainto, Emelia V.; Salgado, Andrea P.; Parish, Austin; Rosellini, Benjamin D.; Ulloa-Gutierrez, Rolando; Garrido, Luis Martin; Dueńas, Lourdes; Estripeaut, Dora; Luciani, Kathia; Rodríguez-Quiroz, Francisco J.; Del Aguila, Olguita; Camacho Moreno, German; Gómez Alba, Virgen; Viviani, Tamara; Álvarez-Olmos, Martha I; de Souza Marques, Heloisa Helena; Faugier-Fuentes, Enrique; Saltigeral-Simental, Patricia; López Medina, Eduardo; Miño-León, Greta; Beltrán, Sandra; Martínez-Arellano, Lucila; Pírez, María Catalina; Cofré, Fernanda; Tremoulet, Adriana H.; REKAMLATINA-2 Study Group Investigators
• Tipo de recurso: Article of journal
• Fecha de publicación: 2020
• Institución: Universidad El Bosque
• Repositorio: Repositorio U. El Bosque
• Idioma: eng
• OAI Identifier: oai:repositorio.unbosque.edu.co:20.500.12495/3744
• Acceso en línea: http://hdl.handle.net/20.500.12495/3744; https://doi.org/10.3389/fped.2020.00384; https://repositorio.unbosque.edu.co
• Palabra clave: Coronary artery abnormalities; Delayed diagnosis; Infants; Kawasaki disease
• Rights: openAccess
• License: Attribution 4.0 International