AUTHOR=Moreno Elizabeth , Garcia S. Diana , Bainto Emelia , Salgado Andrea P. , Parish Austin , Rosellini Benjamin D. , Ulloa-Gutierrez Rolando , Garrido-Garcia Luis M. , Dueñas Lourdes , Estripeaut Dora , Luciani Kathia , Rodríguez-Quiroz Francisco J. , del Aguila Olguita , Camacho-Moreno Germán , Gómez Virgen , Viviani Tamara , Alvarez-Olmos Martha I. , de Souza Marques Heloisa Helena , Faugier-Fuentes Enrique , Saltigeral-Simental Patricia , López-Medina Eduardo , Miño-León Greta , Beltrán Sandra , Martínez-Medina Lucila , Pirez Maria C. , Cofré Fernanda , Tremoulet Adriana H. 

TITLE=Presentation and Outcomes of Kawasaki Disease in Latin American Infants Younger Than 6 Months of Age: A Multinational Multicenter Study of the REKAMLATINA Network

JOURNAL=Frontiers in Pediatrics

VOLUME=8

YEAR=2020

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.00384

DOI=10.3389/fped.2020.00384

ISSN=2296-2360

ABSTRACT=<p><bold>Objective:</bold> To characterize the clinical presentation and outcomes of Kawasaki disease (KD) in infants &lt;6 months of age as compared to those ≥6 months in Latin America.</p><p><bold>Methods:</bold> We evaluated 36 infants &lt;6 months old and 940 infants ≥6 months old diagnosed with KD in Latin America. We compared differences in laboratory data, clinical presentation, treatment response, and coronary artery outcomes between the two cohorts.</p><p><bold>Results:</bold> The majority (78.1%) of infants and children ≥6 months of age were initially diagnosed with KD, as compared to only 38.2% of infants &lt;6 months. Clinical features of KD were more commonly observed in the older cohort: oral changes (92 vs. 75%, <italic>P</italic> = 0.0023), extremity changes (74.6 vs. 57.1%, <italic>P</italic> = 0.029), and cervical lymphadenopathy (67.6 vs. 37.1%, <italic>P</italic> = 0.0004). Whether treated in the first 10 days of illness or after the 10th day, infants &lt;6 months were at greater risk of developing a coronary artery aneurysm compared to KD patients ≥6 months treated at the same point in the course of illness [ ≤ 10 days (53.8 vs. 9.4%, <italic>P</italic> = 0.00012); &gt;10 days (50 vs. 7.4%, <italic>P</italic> = 0.043)].</p><p><bold>Conclusion:</bold> Our data show that despite treatment in the first 10 days of illness, infants &lt;6 months of age in Latin America have a higher risk of developing a coronary artery aneurysm. Delay in the diagnosis leads to larger coronary artery aneurysms disproportionately in these infants. Thus, suspicion for KD should be high in this vulnerable population.</p>