Frontiers in Pediatrics (Sep 2020)
Use of Adjunctive Therapy in Acute Kawasaki Disease in Latin America
- Brenda Fortuna-Reyna,
- Emelia V. Bainto,
- Emelia V. Bainto,
- Rolando Ulloa-Gutierrez,
- Rolando Ulloa-Gutierrez,
- Luis M. Garrido-García,
- Dora Estripeaut,
- Olguita del Águila,
- Virgen Gómez,
- Enrique Faugier-Fuentes,
- Greta Miño-León,
- Sandra Beltrán,
- Fernanda Cofré,
- Enrique Chacón-Cruz,
- Patricia Saltigeral-Simental,
- Lucila Martínez-Medina,
- Lourdes Dueñas,
- Kathia Luciani,
- Francisco J. Rodríguez-Quiroz,
- German Camacho-Moreno,
- Tamara Viviani,
- Martha I. Alvarez-Olmos,
- Heloisa Helena de Sousa Marques,
- Eduardo López-Medina,
- María C. Pirez,
- Adriana H. Tremoulet,
- Adriana H. Tremoulet
Affiliations
- 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
- Emelia V. Bainto
- 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
- Rolando Ulloa-Gutierrez
- Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica
- Luis M. Garrido-García
- Servicio de Cardiología, Instituto Nacional de Pediatría, Ciudad de México, Mexico
- 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
- 0Servicio de Reumatología, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
- Greta Miño-León
- 1Servicio de Infectología, Hospital del Niño “Francisco de Icaza Bustamante”, Guayaquil, Ecuador
- Sandra Beltrán
- 2Servicio de Infectología, Clínica Colsanitas, Bogotá, Colombia
- Fernanda Cofré
- 3Servicio de Infectología, Hospital Roberto del Río, Santiago, Chile
- Enrique Chacón-Cruz
- 4Servicio de Infectología, Hospital General de Tijuana, Tijuana, Mexico
- Patricia Saltigeral-Simental
- 5Servicio de Infectología, Instituto Nacional de Pediatría y Hospital Infantil Privado, Ciudad de México, Mexico
- Lucila Martínez-Medina
- 6Servicio de Infectología, Centenario Hospital Miguel Hidalgo, Aguascalientes, Mexico
- Lourdes Dueñas
- 7Servicio de Infectología, Hospital de Niños Benjamín Bloom, San Salvador, El Salvador
- Kathia Luciani
- 8Servicio de Infectología, Hospital de Especialidades Pediátricas Omar Torrijos Herrera, Caja de Seguro Social, Ciudad de Panamá, Panama
- Francisco J. Rodríguez-Quiroz
- 9Servicio de Reumatología, Instituto Hondureño de Seguridad Social, Tegucigalpa, Honduras
- German Camacho-Moreno
- 0Servicio de Infectología, Fundación HOMI Hospital Pediátrico de la Misericordia & Universidad Nacional de Colombia, Bogotá, Colombia
- Tamara Viviani
- 1Servicio de Infectología, Hospital Sotero del Río, Santiago, Chile
- Martha I. Alvarez-Olmos
- 2Servicio de Infectología, Fundación Cardioinfantil & Universidad El Bosque, Bogotá, Colombia
- Heloisa Helena de Sousa Marques
- 3Servicio de Infectología, Hospital Das Clinicas da Faculdade Medicina de la USP, São Paolo, Brazil
- Eduardo López-Medina
- 4Centro de Estudios en Infectología Pediátrica, Departamento de Pediatría, Universidad del Valle y Centro Médico Imbanaco, Cali, Colombia
- María C. Pirez
- 5Servicio de Infectología, Hospital Pediátrico Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
- Adriana H. Tremoulet
- University of California, San Diego, San Diego, CA, United States
- Adriana H. Tremoulet
- California/Rady Children's Hospital San Diego, San Diego, CA, United States
- DOI
- https://doi.org/10.3389/fped.2020.00442
- Journal volume & issue
-
Vol. 8
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.
Keywords
