AUTHOR=Fortuna-Reyna Brenda , Bainto Emelia V. , Ulloa-Gutierrez Rolando , Garrido-García Luis M. , Estripeaut Dora , del Águila Olguita , Gómez Virgen , Faugier-Fuentes Enrique , Miño-León Greta , Beltrán Sandra , Cofré Fernanda , Chacón-Cruz Enrique , Saltigeral-Simental Patricia , Martínez-Medina Lucila , Dueñas Lourdes , Luciani Kathia , Rodríguez-Quiroz Francisco J. , Camacho-Moreno German , Viviani Tamara , Alvarez-Olmos Martha I. , Marques Heloisa Helena de Sousa , López-Medina Eduardo , Pirez María C. , Tremoulet Adriana H. , The Kawasaki Disease REKAMLATINA Network Study Group
TITLE=Use of Adjunctive Therapy in Acute Kawasaki Disease in Latin America
JOURNAL=Frontiers in Pediatrics
VOLUME=8
YEAR=2020
URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.00442
DOI=10.3389/fped.2020.00442
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.