Epidemiological and clinical features of Kawasaki disease in Spain over 5 years and risk factors for aneurysm development. (2011-2016): KAWA-RACE study group

Kawasaki disease (KD) is an acute self-limited systemic vasculitis of unknown etiology affecting mainly children less than 5 years of age. Risk factors for cardiac involvement and resistance to treatment are insufficiently studied in non-Japanese children. This study aimed to investigate the epidemi...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2019-05, Vol.14 (5), p.e0215665-e0215665
Main Authors: Fernandez-Cooke, Elisa, Barrios Tascón, Ana, Sánchez-Manubens, Judith, Antón, Jordi, Grasa Lozano, Carlos Daniel, Aracil Santos, Javier, Villalobos Pinto, Enrique, Clemente Garulo, Daniel, Mercader Rodríguez, Beatriz, Bustillo Alonso, Matilde, Nuñez Cuadros, Esmeralda, Navarro Gómez, Maria Luisa, Domínguez-Rodríguez, Sara, Calvo, Cristina
Format: Article
Language:English
Subjects:
Adolescent
Anemia
Aneurysm
Aneurysms
Biology and Life Sciences
Care and treatment
Child
Child, Preschool
Children
Children & youth
Coronary Aneurysm - complications
Coronary artery
Coronary vessels
Creatinine
Development and progression
Disease control
Drug resistance
Epidemiology
Etiology
Etiology (Medicine)
Female
Fever
Gene expression
Glycosylated hemoglobin
Health risks
Heart
Hemoglobin
Hemoglobins
Hospitals
Humans
Hyponatremia
Immunoglobulins
Infant
Infants
Infliximab
Intravenous administration
Kawasaki disease
Kawasaki syndrome
Laboratories
Lesions
Leukocytosis
Male
Males
Maximum temperatures
Medical research
Medicine and Health Sciences
Monoclonal antibodies
Mucocutaneous lymph node syndrome
Mucocutaneous Lymph Node Syndrome - complications
Mucocutaneous Lymph Node Syndrome - diagnosis
Mucocutaneous Lymph Node Syndrome - epidemiology
Mucocutaneous Lymph Node Syndrome - therapy
Multivariate analysis
Patients
Pediatrics
Physical Sciences
Platelets
Procalcitonin
Prognosis
Resistance factors
Rheumatology
Risk analysis
Risk Factors
Spain - epidemiology
Steroid hormones
Steroids
Studies
Surveillance
Systemic vasculitis
Treatment Outcome
Vasculitis
Veins & arteries
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Kawasaki disease (KD) is an acute self-limited systemic vasculitis of unknown etiology affecting mainly children less than 5 years of age. Risk factors for cardiac involvement and resistance to treatment are insufficiently studied in non-Japanese children. This study aimed to investigate the epidemiology, clinical features and risk factors for resistance to treatment and coronary artery lesions (CAL) in KD in Spain. Retrospective study (May 2011-June 2016) of all patients less than 16 years of age diagnosed with KD included in KAWA-RACE network (84 Spanish hospitals). A total of 625 cases were analyzed, 63% were males, 79% under 5 year-olds and 16.8% younger than 12 months. On echocardiographic examination CAL were the most frequent findings (23%) being ectasia the most common (12%). Coronary aneurysms were diagnosed in 9.6%, reaching 20% in infants under 12 months (p 900,000 cells/mm3, maximum temperature < 39.5°C, total duration of fever > 10 days and fever before treatment ≥ 8 days as independent risk factors for developing coronary aneurysms. In our population, children under 12 months develop coronary aneurysms more frequently and children with KD with anemia and leukocytosis have high risk of cardiac involvement. Adding steroids early should be considered in those patients, especially if the treatment is not started before 8 days of fever. A score applicable to non-Japanese children able to predict the risk of aneurysm development and IVIG resistance is necessary.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0215665