1. Use of Adjunctive Therapy in Acute Kawasaki Disease in Latin America
- 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, and Adriana H. Tremoulet
- Subjects
Kawasaki disease ,Latin America ,steroids ,infliximab ,adjunctive therapy ,Pediatrics ,RJ1-570 - 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.
- Published
- 2020
- Full Text
- View/download PDF