학술논문
Use of Adjunctive Therapy in Acute Kawasaki Disease in Latin America
Document Type
article
Author
Brenda Fortuna-Reyna; Emelia V. Bainto; 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
Source
Frontiers in Pediatrics, Vol 8 (2020)
Subject
Language
English
ISSN
2296-2360
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.