Epidemiological and clinical features of Kawasaki disease in Spain over 5 years and risk factors for aneurysm development. (2011-2016): KAWA-RACE study group

Background Kawasaki disease (KD) is an acute self-limited systemic vasculitis of unknown etiology affecting mainly children less than 5 years of age. Risk factors for cardiac involvement and resistance to treatment are insufficiently studied in non-Japanese children. Objective This study aimed to in...

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Autores: Fernandez-Cooke, Elisa, Barrios Tascon, Ana, Sanchez-Manubens, Judith, Anton, Jordi, Grasa Lozano, Carlos Daniel, Aracil Santos, Javier, Villalobos Pinto, Enrique, Clemente Garulo, Daniel, Mercader Rodriguez, Beatriz, Bustillo, Matilde, Nunez Cuadros, Esmeralda, Navarro Gomez, Maria Luisa, Dominguez-Rodriguez, Sara, Calvo, Cristina, Moreno Perez, David, Martin Cantero, Maria, Carazo Gallego, Begoña, Martinez Campos, Leticia Isabel, Sanchez Garcia, Fernando, Camacho Lovillo, Marisol, Marques, Renata, Neth, Olaf, Fernandez Silveira, Laura, Sanchez Forte, Miguel, Ortega Montes, Angeles, Bravo Mancheno, Beatriz, Camacho, Margarita, Medina Claros, Antonio F., Salido Peracaula, Carlos, Chulian Cruz, Rafael, Torres Rico, Maria, Tejero Hernandez, Maria Angeles, Gomez Guzman, Elena, Arroyo Marin, Ma Jose, Rumbao Aguirre, Jose, Lirola Cruz, Ma Jose, Maya Carrasco, Kety, Rodriguez Gonzalez, Moises, Blanca Jover, Enrique, Ruiz Lopez, Aida, Uberos Fernandez, Jose, Ibanez Alcalde, Maria Mercedes, Collado, Pilar, Guerrero Laleona, Carmelo, Jimenez Montanes, Lorenzo, Ayerza Casas, Ariadna, Montes Zapico, Barbara, Perez Mendez, Carlos, Fernandez Aracama, Javier, Rodriguez, Lucia, Ibanez Fernandez, Maria Aleida, Navarro Campo, Sandra, Escribá-Bori, Silvia, Mir Perelló, Maria Concepción, de la Fuente Sanchez, Maria Angeles, Aparicio Garcia, Patricia, Briales, Carlos, Castilla Crespi, Joaquin, Colino, Elena, Delgado Cabrera, Nerea, Bello Naranjo, Ana, Poch Paez, Jesus, Garcia Yanez, Moneyba, Gonzalez Garcia, Montse, Pereira Bezanilla, Elena, Jimenez Montero, Beatriz, Dominguez Garcia, Olga, Losada Pinedo, Begona, Inigo Martin, Gema, Escribano Gomez, Lucia Maria, Cepillo, Antonio, Lillo Lillo, Miguel, Isabel Buedo, Maria, del Rey Megias, Laura, Urbaneja Rodriguez, Elena, Rellan Rodriguez, Sara, Cantero Tejedor, Maria Teresa, Plata Izquierdo, Beatriz, Garcia-Cuenllas Alvarez, Luisa, Oulego Erroz, Ignacio, Perez Santaolalla, Elena, Alcalde Martin, Carlos, Centeno Malfaz, Fernando, Perez Gutierrez, Elena, Jimenez Casso, Marisol, Prada, Fredy, Bou-Torrent, Rosa, Iglesias, Estibaliz, Calzada, Joan, Calavia Garsaball, Olga, Tobena Rue, Marc, Giralt Garcia, Gemma, Yevenes Ruiz, Silvia, Lobato, Zulema, Rius Gordillo, Neus, Pascual Torres, Montserrat, Mendez Hernandez, Maria, Garcia, Lourdes, Flores Villar, Sergio, Minguell Domingo, Laura, Ballester, Anna, Miralles, Ana, Pujol Soler, Berta, Foguet-Vidal, Anton, Sala Castellvi, Pere, Serrano Aguiar, Angelita, Siurana Rodriguez, Jose Manuel, Sangorrin Iranzo, Anna, Alvarez Perez, Roser, Ribes Cajas, Paula, Genaro i Jornet, Pere, Grande Tejada, Ana, Zarallo, Cristina, Martinon-Torres, Federico, Rivero Calle, Irene, Justicia Grande, Antonio, Ruiz Saez, Beatriz, Lopez Sousa, Maria, Souto Vilas, Alejandro, Lopez Abe, Bernardo, de Miguel Esteban, Elisa, Riano Mendez, Bibiana, Blazquez, Daniel, Rojo Conejo, Pablo, Gonzalez Tome, Maribel, Grasa Lozano, Carlos, Toral Vazquez, Belen, Albert de la Torre, Leticia, de Inocencio, Jaime, Santos, Mar, Diaz-Delgado de la Pena, Rafael, Collado Ramos, Paz, Tagarro-García, Alfredo, Raga, Teresa, Latorre, Libertad, Guillen, Sara, Callejas Caballero, Ignacio, Prieto Tato, Luis Manuel, Guzman Monagas, Maria Fernanda, Jimenez Lopez, Isabel, Villagra, Sandra, Arreo, Viviana, Pineiro Perez, Roi, de la Parte Cancho, Maria, Tamariz-Martes, Amalia, Llorente Romano, Marta, Hernandez Ruperez, Belen, Rodriguez Martin, Sonia, Rojo Sombrero, Henar, Garcia Cerro, Estefania, Mate Cano, Irene, Villares Alonso, Marta, Osuna Marco, Marta Pilar, Jensen Veron, Julia, Rodriguez Mesa, Maria Dolores, Rueda Esteban, Santiago, Ramos Amador, Jose Tomas, Gonzalez Menchen, Cristina, Jimenez Jimenez, Ana Belen, Galan, Pilar, Perez Campos, Dolores, Mercedes Bueno, Ma, Crespo Marcos, David, Otheo de Tejada Barasoain, Enrique, Sifuentes Giraldo, Walter Alberto, Gamir Gamir, Maria Luz, Cilleruelo Ortega, Maria Jose, Lopez Lopez, Agustin, Sanchez Vaquerizo, Cristina, Usano Carrasco, Ana Isabel, Moreno Gomez, Ester, Carrasco Colom, Jaime, Carvajal del Castillo, Olga, del Pozo Menendez, Beatriz, Badillo Navarro, Katie, Baquero, Fernando, Deiros Bronte, Lucia, Fernandez Fraga, Pablo, Dominguez, Nieves, Castro Garcia, Francisco, Vera Romero, Elena, Herrera Chamorro, Agueda, Alcaniz-Rodriguez, Paula, Sorli Garcia, Moises, Rex Nicolas, Maria Concepcion, Lorente Nicolas, Ana, Martinez Oloron, Patricia, Rocandio Cilveti, Beatriz, Berridi, Amaia, Santos-Diez Vazquez, Laura, Fernandez, Olaia, Perez Tamarit, Amparo, Calvo, Inmaculada, Lopez, Berta, Gonzalez Fernandez, Ma Isabel, Otero, Ma Carmen, Oltra, Manuel, Dapena Archiles, Marta, Sanchez, Paco, Gavilan, Cesar, Izquierdo Fos, Ignacio, Serrano Robles, Maria Isabel, Herranz Sanchez, Yolanda, KAWA-RACE Study Grp
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/16953
Acceso en línea:https://hdl.handle.net/20.500.13003/16953
Access Level:acceso abierto
Palabra clave:Infant
Prognosis
Male
Female
Risk Factors
Treatment Outcome
Mucocutaneous Lymph Node Syndrome
Spain
Coronary Aneurysm
Humans
Child, Preschool
Adolescent
Child
España
Resultado del Tratamiento
Síndrome Mucocutáneo Linfonodular
Femenino
Lactante
Adolescente
Masculino
Factores de Riesgo
Preescolar
Humanos
Aneurisma Coronario
Pronóstico
Niño
Descripción
Sumario:Background Kawasaki disease (KD) is an acute self-limited systemic vasculitis of unknown etiology affecting mainly children less than 5 years of age. Risk factors for cardiac involvement and resistance to treatment are insufficiently studied in non-Japanese children. Objective This study aimed to investigate the epidemiology, clinical features and risk factors for resistance to treatment and coronary artery lesions (CAL) in KD in Spain. Methods Retrospective study (May 2011-June 2016) of all patients less than 16 years of age diagnosed with KD included in KAWA-RACE network (84 Spanish hospitals). Results A total of 625 cases were analyzed, 63% were males, 79% under 5 year-olds and 16.8% younger than 12 months. On echocardiographic examination CAL were the most frequent findings (23%) being ectasia the most common (12%). Coronary aneurysms were diagnosed in 9.6%, reaching 20% in infants under 12 months (p<0.001). A total of 97% of the patients received intravenous immunoglobulin (IVIG) with a median number of days from fever onset to IVIG administration of 7.2. A second dose was given to 15.7% and steroids to 14.5% patients. Only 1.4% patients received infliximab. No deaths were reported. A multivariate analysis identified anemia, hypoalbuminemia, hyponatremia, higher creatinine and procalcitonin as independent risk factors for treatment failure and length under 103 cm, hemoglobin < 10.2 mg/dL, platelets > 900,000 cells/mm(3), maximum temperature < 39.5 degrees C, total duration of fever > 10 days and fever before treatment >= 8 days as independent risk factors for developing coronary aneurysms. Conclusions In our population, children under 12 months develop coronary aneurysms more frequently and children with KD with anemia and leukocytosis have high risk of cardiac involvement. Adding steroids early should be considered in those patients, especially if the treatment is not started before 8 days of fever. A score applicable to non-Japanese children able to predict the risk of aneurysm development and IVIG resistance is necessary.

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