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...

Descripción completa

Detalles Bibliográficos
Autores: Fernandez-Cooke, E., Tascon, A. B., Sanchez-Manubens, J., Anton, J., Lozano, C. D. G., Santos, J. A., Pinto, E. V., Garulo, D. C., Rodriguez, B. M., Alonso, M. B., Cuadros, E. N., Gomez, M. L. N., Dominguez-Rodriguez, S., Calvo, C., Perez, D. M., Cantero, M. M., Gallego, B. C., Campos, L. I. M., Garcia, F. S., Lovillo, M. C., Marques, R., Neth, O., Silveira, L. F., Forte, M. S., Montes, A. O., Mancheno, B. B., Camacho, M., Claros, A. F. M., Salido, C., Cruz, R. C., Rico, M. T., Hernandez, M. A. T., Guzman, E. G., Marin, M. J. A., Aguirre, J. R., Cruz, M. J. L., Carrasco, K. M., Gonzalez, M. R., Jover, E. B., Lopez, A. R., Fernandez, J. U., Alcalde, M. M. I., Collado, P., Laleona, C. G., Montanes, L. J., Casas, A. A., Zapico, B. M., Mendez, C. P., Aracama, J. F., Rodriguez, L., Fernandez, M. A. I., Campo, S. N., Bori, S. E., Perello, M. C. M., Sanchez, M. A. D., Garcia, P. A., Briales, C., Crespi, J. C., Gil, M. E. C., Cabrera, N. D., Naranjo, A. B., Paez, J. P., Yanez, M. G., Garcia, M. G., Bezanilla, E. P., Montero, B. J., Garcia, O. D., Pinedo, B. L., Martin, G. I., Gomez, L. M. E., Cepillo, A., Lillo, M., Buedo, M. I., del Rey, L., Rodriguez, E. U., Rodriguez, S. R., Cantero, T., Izquierdo, B. P., Alvarez, L. G. C., Erroz, I. O., Santaolalla, E. P., Martin, C. A., Malfaz, F. C., Gutierrez, E. P., Casso, M. J., Prada, F., Bou, R., Iglesias, E., Calzada, J., Garsaball, O. C., Rue, M. T., Garcia, G. G., Ruiz, S. Y., Lobato, Z., Gordillo, N. R., Torres, M. P., Hernandez, M. M., Garcia, L., Villar, S. F., Domingo, L. M., Ballester, A., Miralles, A., Soler, B. P., Vidal, A. F., Castellvi, P. S., Aguiar, A. S., Rodriguez, J. M. S., Iranzo, A. S., Perez, R. A., Cajas, P. R., Jornet, P. G. I., Tejada, A. G., Zarallo, C., Martinón Torres, Federico, Rivero Calle, Irene, Justicia Grande, Antonio José, Saez, B. R., López Sousa, María, Souto Vilas, Alejandro, Abe, B. L., Esteban, E. D., Mendez, B. R., Blazquez, D., Conejo, P. R., Tome, M. G., Lozano, C. G., Toral, B., De la Torre, L. A., de Inocencio, J., Santos, M., de la Pena, R. D. D., Ramos, P. C., Tagarro, A., Raga, T., Latorre, L., Guillen, S., Caballero, I. C., Tato, L. M. P., Monagas, M. F. G., Lopez, I. J., Villagra, S., Arreo, V., Perez, R. P., de la Parte, M., Tamariz-Martes, A., Romano, M. L., Ruperez, B. H., Martin, S. R., Sombrero, H. R., Cerro, E. G., Cano, I. M., Alonso, M. V., Marco, M. P. O., Veron, J. J., Mesa, M. D. R., Esteban, S. R., Amador, J. T. R., Menchen, C. G., Jimenez, A. B., Galan, P., Campos, D. P., Bueno, M. M., Marcos, D. C., Barasoain, E. O. D., Giraldo, W. A. S., Gamir, M. L., Ortega, M. J. C., Lopez, A., Vaquerizo, C. S., Carrasco, A. I. U., Gomez, E. M., Colom, J. C., del Castillo, O. C., Menendez, B. D., Navarro, K. B., Baquero, F., Bronte, L. D., Fraga, P. F., Dominguez, N., Garcia, F. C., Romero, E. V., Chamorro, A. H., Rodriguez, P. A., Garcia, M. S., Nicolas, M. C. R., Nicolas, A. L., Oloron, P. M., Cilveti, B. R., Berridi, A., Vazquez, L. S. D., Fernandez, O., Tamarit, A. P., Calvo, I., Lopez, B., Fernandez, M. I. G., Otero, M. C., Oltra, M., Archiles, M. D., Sanchez, P., Gavilan, C., Fos, II, Robles, M. I. S., Sanchez, Y. H.
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Servizo Galego de Saúde (SERGAS)
Repositorio:RUNA. Repositorio da Consellería de Sanidade e Sergas
OAI Identifier:oai:runa.sergas.gal:20.500.11940/15629
Acceso en línea:https://www.ncbi.nlm.nih.gov/pubmed/31107862
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6527399/pdf/pone.0215665.pdf
http://hdl.handle.net/20.500.11940/15629
Access Level:acceso abierto
Palabra clave:Risk Factors
Mucocutaneous Lymph Node Syndrome
Humans
Treatment Outcome
Adolescent
Coronary Aneurysm
Prognosis
Infant
pronóstico
resultado del tratamiento
factores de riesgo
lactante
humanos
síndrome mucocutáneo linfonodular
aneurisma coronario
adolescente
CHUS
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/mm3, 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.

Similares en LA Referencia