Clinical Presentation and Outcomes of Kawasaki Disease in Children from Latin America : A Multicenter Observational Study from the REKAMLATINA Network
Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved..
OBJECTIVES: To describe the clinical presentation, management, and outcomes of Kawasaki disease (KD) in Latin America and to evaluate early prognostic indicators of coronary artery aneurysm (CAA).
STUDY DESIGN: An observational KD registry-based study was conducted in 64 participating pediatric centers across 19 Latin American countries retrospectively between January 1, 2009, and December 31, 2013, and prospectively from June 1, 2014, to May 31, 2017. Demographic and initial clinical and laboratory data were collected. Logistic regression incorporating clinical factors and maximum coronary artery z-score at initial presentation (between 10 days before and 5 days after intravenous immunoglobulin [IVIG]) was used to develop a prognostic model for CAA during follow-up (>5 days after IVIG).
RESULTS: Of 1853 patients with KD, delayed admission (>10 days after fever onset) occurred in 16%, 25% had incomplete KD, and 11% were resistant to IVIG. Among 671 subjects with reported coronary artery z-score during follow-up (median: 79 days; IQR: 36, 186), 21% had CAA, including 4% with giant aneurysms. A simple prognostic model utilizing only a maximum coronary artery z-score ≥2.5 at initial presentation was optimal to predict CAA during follow-up (area under the curve: 0.84; 95% CI: 0.80, 0.88).
CONCLUSION: From our Latin American population, coronary artery z-score ≥2.5 at initial presentation was the most important prognostic factor preceding CAA during follow-up. These results highlight the importance of early echocardiography during the initial presentation of KD.
| Errataetall: |
CommentIn: Arch Dis Child. 2023 Nov;108(11):915. - PMID 37903536 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:263 |
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| Enthalten in: |
The Journal of pediatrics - 263(2023) vom: 02. Dez., Seite 113346 |
| Sprache: |
Englisch |
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| Links: |
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| Themen: |
Coronary artery aneurysm |
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| Anmerkungen: |
Date Completed 04.12.2023 Date Revised 12.02.2024 published: Print-Electronic CommentIn: Arch Dis Child. 2023 Nov;108(11):915. - PMID 37903536 Citation Status MEDLINE |
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| doi: |
10.1016/j.jpeds.2023.02.001 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM352847824 |
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| 100 | 1 | |a Narayan, Hari K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical Presentation and Outcomes of Kawasaki Disease in Children from Latin America |b A Multicenter Observational Study from the REKAMLATINA Network |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 04.12.2023 | ||
| 500 | |a Date Revised 12.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Arch Dis Child. 2023 Nov;108(11):915. - PMID 37903536 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: To describe the clinical presentation, management, and outcomes of Kawasaki disease (KD) in Latin America and to evaluate early prognostic indicators of coronary artery aneurysm (CAA) | ||
| 520 | |a STUDY DESIGN: An observational KD registry-based study was conducted in 64 participating pediatric centers across 19 Latin American countries retrospectively between January 1, 2009, and December 31, 2013, and prospectively from June 1, 2014, to May 31, 2017. Demographic and initial clinical and laboratory data were collected. Logistic regression incorporating clinical factors and maximum coronary artery z-score at initial presentation (between 10 days before and 5 days after intravenous immunoglobulin [IVIG]) was used to develop a prognostic model for CAA during follow-up (>5 days after IVIG) | ||
| 520 | |a RESULTS: Of 1853 patients with KD, delayed admission (>10 days after fever onset) occurred in 16%, 25% had incomplete KD, and 11% were resistant to IVIG. Among 671 subjects with reported coronary artery z-score during follow-up (median: 79 days; IQR: 36, 186), 21% had CAA, including 4% with giant aneurysms. A simple prognostic model utilizing only a maximum coronary artery z-score ≥2.5 at initial presentation was optimal to predict CAA during follow-up (area under the curve: 0.84; 95% CI: 0.80, 0.88) | ||
| 520 | |a CONCLUSION: From our Latin American population, coronary artery z-score ≥2.5 at initial presentation was the most important prognostic factor preceding CAA during follow-up. These results highlight the importance of early echocardiography during the initial presentation of KD | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Kawasaki syndrome | |
| 650 | 4 | |a Latin America | |
| 650 | 4 | |a coronary artery aneurysm | |
| 650 | 4 | |a pediatric | |
| 650 | 7 | |a Immunoglobulins, Intravenous |2 NLM | |
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| 700 | 1 | |a Ulloa-Gutierrez, Rolando |e verfasserin |4 aut | |
| 700 | 1 | |a Bainto, Emelia V |e verfasserin |4 aut | |
| 700 | 1 | |a Garrido-García, Luis M |e verfasserin |4 aut | |
| 700 | 1 | |a Estripeaut, Dora |e verfasserin |4 aut | |
| 700 | 1 | |a Del Aguila, Olguita |e verfasserin |4 aut | |
| 700 | 1 | |a Gómez, Virgen |e verfasserin |4 aut | |
| 700 | 1 | |a Faugier-Fuentes, Enrique |e verfasserin |4 aut | |
| 700 | 1 | |a Miño-León, Greta |e verfasserin |4 aut | |
| 700 | 1 | |a Beltrán, Sandra |e verfasserin |4 aut | |
| 700 | 1 | |a Cofré, Fernanda |e verfasserin |4 aut | |
| 700 | 1 | |a Chacon-Cruz, Enrique |e verfasserin |4 aut | |
| 700 | 1 | |a Saltigeral-Simental, Patricia |e verfasserin |4 aut | |
| 700 | 1 | |a Martínez-Medina, Lucila |e verfasserin |4 aut | |
| 700 | 1 | |a Dueñas, Lourdes |e verfasserin |4 aut | |
| 700 | 1 | |a Luciani, Kathia |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez-Quiroz, Francisco J |e verfasserin |4 aut | |
| 700 | 1 | |a Camacho Moreno, Germán |e verfasserin |4 aut | |
| 700 | 1 | |a Viviani, Tamara |e verfasserin |4 aut | |
| 700 | 1 | |a Alvarez-Olmos, Martha I |e verfasserin |4 aut | |
| 700 | 1 | |a Marques, Heloisa Helena de Sousa |e verfasserin |4 aut | |
| 700 | 1 | |a López-Medina, Eduardo |e verfasserin |4 aut | |
| 700 | 1 | |a Pirez, María C |e verfasserin |4 aut | |
| 700 | 1 | |a Tremoulet, Adriana H |e verfasserin |4 aut | |
| 700 | 0 | |a Kawasaki Disease REKAMLATINA Network Study Group |e verfasserin |4 aut | |
| 700 | 1 | |a Gámez-González, Luisa B |e investigator |4 oth | |
| 700 | 1 | |a Pérez-Camacho, Paola |e investigator |4 oth | |
| 700 | 1 | |a Patiño, Jaime |e investigator |4 oth | |
| 700 | 1 | |a Cleves, Daniela |e investigator |4 oth | |
| 700 | 1 | |a Franco, Lorena |e investigator |4 oth | |
| 700 | 1 | |a Avila-Agüero, Maria L |e investigator |4 oth | |
| 700 | 1 | |a Camacho-Badilla, Kattia |e investigator |4 oth | |
| 700 | 1 | |a Soriano-Fallas, Alejandra |e investigator |4 oth | |
| 700 | 1 | |a Li-Chan, Susan |e investigator |4 oth | |
| 700 | 1 | |a Valverde, Kathia |e investigator |4 oth | |
| 700 | 1 | |a Collia, Adrián |e investigator |4 oth | |
| 700 | 1 | |a Ellis, Alejandro |e investigator |4 oth | |
| 700 | 1 | |a Grazioso, Carlos F |e investigator |4 oth | |
| 700 | 1 | |a Grazioso, Pablo J |e investigator |4 oth | |
| 700 | 1 | |a Calvimontes, Gonzalo |e investigator |4 oth | |
| 700 | 1 | |a Izquierdo, Giannina |e investigator |4 oth | |
| 700 | 1 | |a Picart, Pilar |e investigator |4 oth | |
| 700 | 1 | |a Melgar, Mario |e investigator |4 oth | |
| 700 | 1 | |a Salgado, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Borzutzky, Arturo |e investigator |4 oth | |
| 700 | 1 | |a Arbo, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Lovera, Dolores |e investigator |4 oth | |
| 700 | 1 | |a Amarilla, Sara |e investigator |4 oth | |
| 700 | 1 | |a Galeano, Fernando |e investigator |4 oth | |
| 700 | 1 | |a Astigarraga, Norma |e investigator |4 oth | |
| 700 | 1 | |a Luis-Álvarez, Maria Del Carmen |e investigator |4 oth | |
| 700 | 1 | |a Fynn, Estefanía |e investigator |4 oth | |
| 700 | 1 | |a Assandri, Elizabeth |e investigator |4 oth | |
| 700 | 1 | |a Levy, Jacqueline |e investigator |4 oth | |
| 700 | 1 | |a Castaño, Elizabeth |e investigator |4 oth | |
| 700 | 1 | |a Esquivel, Raúl |e investigator |4 oth | |
| 700 | 1 | |a Norero, Ximena |e investigator |4 oth | |
| 700 | 1 | |a Sinisterra, Scarlet |e investigator |4 oth | |
| 700 | 1 | |a Daza, Carlos |e investigator |4 oth | |
| 700 | 1 | |a Record, Javier |e investigator |4 oth | |
| 700 | 1 | |a Hurtado-Palacios, Isabel C |e investigator |4 oth | |
| 700 | 1 | |a Madrid, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Calvache-Burbano, Angélica |e investigator |4 oth | |
| 700 | 1 | |a Fernández, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Sánchez, Yasmín |e investigator |4 oth | |
| 700 | 1 | |a Freire, Dolores |e investigator |4 oth | |
| 700 | 1 | |a Yamazaki-Nakashimada, Marco A |e investigator |4 oth | |
| 700 | 1 | |a Rodríguez-Herrera, Raymundo |e investigator |4 oth | |
| 700 | 1 | |a López-Gallegos, Diana |e investigator |4 oth | |
| 700 | 1 | |a Márquez-González, Horacio |e investigator |4 oth | |
| 700 | 1 | |a Díaz-Maldonado, Adriana |e investigator |4 oth | |
| 700 | 1 | |a Marquez-Herrera, Kelly |e investigator |4 oth | |
| 700 | 1 | |a Sakita, Neusa Keico |e investigator |4 oth | |
| 700 | 1 | |a Badue Pereira, María Fernanda |e investigator |4 oth | |
| 700 | 1 | |a Leal, Gabriela Nunes |e investigator |4 oth | |
| 700 | 1 | |a Guarnizo, Pilar |e investigator |4 oth | |
| 700 | 1 | |a Huertas-Quiñones, Manuel |e investigator |4 oth | |
| 700 | 1 | |a López, Pio |e investigator |4 oth | |
| 700 | 1 | |a Deseda-Tous, Jaime |e investigator |4 oth | |
| 700 | 1 | |a Pujadas, Mónica |e investigator |4 oth | |
| 700 | 1 | |a Soza, Guillermo |e investigator |4 oth | |
| 700 | 1 | |a Cerda, Carolina |e investigator |4 oth | |
| 700 | 1 | |a López-Medina, Issa Lorena |e investigator |4 oth | |
| 700 | 1 | |a Hernández-Magaña, Rafael |e investigator |4 oth | |
| 700 | 1 | |a Passos, Saulo Duarte |e investigator |4 oth | |
| 700 | 1 | |a Rubio-Pérez, Nadina |e investigator |4 oth | |
| 700 | 1 | |a García-Rodríguez, Fernando |e investigator |4 oth | |
| 700 | 1 | |a Martínez-Ramírez, Rogelio |e investigator |4 oth | |
| 700 | 1 | |a Rodríguez-Muñoz, Lorena |e investigator |4 oth | |
| 700 | 1 | |a Flores-Hernández, Karina |e investigator |4 oth | |
| 700 | 1 | |a Díaz-Díaz, Alejandro |e investigator |4 oth | |
| 700 | 1 | |a Mesa-Monsalve, Juan G |e investigator |4 oth | |
| 700 | 1 | |a Somarriba, María Mercedes |e investigator |4 oth | |
| 700 | 1 | |a de Lara-Huerta, Jesús |e investigator |4 oth | |
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