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Fortuna-Reyna B, Bainto EV, Ulloa-Gutierrez R, Garrido-García LM, Estripeaut D, Del Águila O, Gómez V, Faugier-Fuentes E, Miño-León G, Beltrán S, Cofré F, Chacón-Cruz E, Saltigeral-Simental P, Martínez-Medina L, Dueñas L, Luciani K, Rodríguez-Quiroz FJ, Camacho-Moreno G, Viviani T, Alvarez-Olmos MI, Marques HHDS, López-Medina E, Pirez MC, Tremoulet AH. Use of Adjunctive Therapy in Acute Kawasaki Disease in Latin America. Front Pediatr 2020; 8:442. [PMID: 33194876 PMCID: PMC7646534 DOI: 10.3389/fped.2020.00442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/25/2020] [Indexed: 11/17/2022] Open
Abstract
Objective: To characterize the use of adjunctive therapy in Kawasaki disease (KD) in Latin America. Methods: The study included 1,418 patients from the Latin American KD Network (REKAMLATINA) treated for KD between January 1, 2009, and May 31, 2017. Results: Of these patients, 1,152 received only a single dose of IVIG, and 266 received additional treatment. Age at onset was similar in both groups (median 2 vs. 2.2 years, respectively). The majority of patients were male (58 vs. 63.9%) and were hospitalized with the first 10 days of fever (85.1 vs. 84.2%). The most common adjunctive therapy administered was steroids for IVIG-resistance, followed by additional doses of IVIG. The use of biologics such as infliximab was limited. KD patients who received adjunctive therapy were more likely to have a lower platelet count and albumin level as well as a higher Z score of the coronary arteries. Conclusion: This is the first report of adjunctive therapies for KD across Latin America. IVIG continues to be the initial and resistance treatment, however, steroids are also used and to a lesser extent, biological therapy such as infliximab. Future studies should address the barriers to therapy in children with acute KD throughout Latin America.
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Affiliation(s)
- Brenda Fortuna-Reyna
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Monterrey, Mexico
| | - Emelia V Bainto
- University of California, San Diego, San Diego, CA, United States.,California/Rady Children's Hospital San Diego, San Diego, CA, United States
| | - Rolando Ulloa-Gutierrez
- Servicio de Infectología, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", San José, Costa Rica.,Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica
| | | | - Dora Estripeaut
- Servicio de Infectología, Hospital del Niño Dr. José Renán Esquivel, Ciudad Panamá, Panama
| | - Olguita Del Águila
- Unidad de Infectología Pediátrica, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Virgen Gómez
- Servicio de Infectología, Centro Médico Universidad Central del Este Hospital y Hospital Infantil "Dr. Robert Reid Cabral", Santo Domingo, Dominican Republic
| | - Enrique Faugier-Fuentes
- Servicio de Reumatología, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
| | - Greta Miño-León
- Servicio de Infectología, Hospital del Niño "Francisco de Icaza Bustamante", Guayaquil, Ecuador
| | - Sandra Beltrán
- Servicio de Infectología, Clínica Colsanitas, Bogotá, Colombia
| | - Fernanda Cofré
- Servicio de Infectología, Hospital Roberto del Río, Santiago, Chile
| | | | | | | | - Lourdes Dueñas
- Servicio de Infectología, Hospital de Niños Benjamín Bloom, San Salvador, El Salvador
| | - Kathia Luciani
- Servicio de Infectología, Hospital de Especialidades Pediátricas Omar Torrijos Herrera, Caja de Seguro Social, Ciudad de Panamá, Panama
| | | | - German Camacho-Moreno
- Servicio de Infectología, Fundación HOMI Hospital Pediátrico de la Misericordia & Universidad Nacional de Colombia, Bogotá, Colombia
| | - Tamara Viviani
- Servicio de Infectología, Hospital Sotero del Río, Santiago, Chile
| | - Martha I Alvarez-Olmos
- Servicio de Infectología, Fundación Cardioinfantil & Universidad El Bosque, Bogotá, Colombia
| | | | - Eduardo López-Medina
- Centro de Estudios en Infectología Pediátrica, Departamento de Pediatría, Universidad del Valle y Centro Médico Imbanaco, Cali, Colombia
| | - María C Pirez
- Servicio de Infectología, Hospital Pediátrico Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - Adriana H Tremoulet
- University of California, San Diego, San Diego, CA, United States.,California/Rady Children's Hospital San Diego, San Diego, CA, United States
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Kim GB. Reality of Kawasaki disease epidemiology. KOREAN JOURNAL OF PEDIATRICS 2019; 62:292-296. [PMID: 31319643 PMCID: PMC6702118 DOI: 10.3345/kjp.2019.00157] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/22/2019] [Indexed: 12/21/2022]
Abstract
Epidemiologic studies of Kawasaki disease (KD) have shown a new pattern or change of its occurrence suggestive of its pathophysiology or risk factors from the first patient with KD reported in 1961. The incidence of KD in Northeast Asian countries including Japan, South Korea, China, and Taiwan is 10–30 times higher than that in the United States and Europe. Knowing the true epidemiology of KD in each country and the availability of publications of KD epidemiology also could benefit general health care providers and general population. This would enable the early detection and treatment of KD, ultimately reducing the incidence of coronary artery complications and mortality. Therefore, efforts to investigate the true epidemiology of KD should be continued in every country using a questionnaire survey, National Health Insurance system data, or combined methods depending on each country’s medical environment to ensure high-quality care of patients with KD.
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Affiliation(s)
- Gi Beom Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
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