Kawasaki disease presenting with hoarseness: A multinational study of the REKAMLATINA network

BACKGROUND: Recently, hoarseness affecting the supraglottic structure has been reported in Kawasaki Disease. The objective of this study was to characterize the frequency of hoarseness in acute KD patients in Latin America. METHODS: We used prospective data from the multinational REKAMLATINA Network (Red de Enfermedad de Kawasaki en America Latina) a total of 865 patients from 20 countries were enrolled during the 3-year study period. Data on hoarseness was available in 858 (99.2%) patients. The clinical and laboratory characteristics between hoarse and non-hoarse KD were compared. RESULTS: Hoarseness was documented in 100 (11.6%) patients. Hoarse patients were younger compared to KD without hoarseness (median age 18 vs. 26 months; p=0.002) and presented with a lower hemoglobin (10.7g/dL vs 11.3g/dL; p= 0.040) and hematocrit levels (32% vs 33%, p=0.048) . CONCLUSIONS: Hoarseness was found to be prevalent as a presenting sign of acute KD in younger children. Anemia may indicate the presence of active inflammation.