Browsing by Author "Bainto, Emelia"

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    Presentation and Outcomes of Kawasaki Disease in Latin American Infants Younger Than 6 Months of Age: A Multinational Multicenter Study of the REKAMLATINA Network
    (2020) Moreno, Elizabeth; Garcia, S. Diana; Bainto, Emelia; Salgado, Andrea P.; Parish, Austin; Rosellini, Benjamin D.; Ulloa-Gutierrez, Rolando; Garrido-Garcia, Luis M.; Duenas, Lourdes; Estripeaut, Dora; Luciani, Kathia; Rodriguez-Quiroz, Francisco J.; del Aguila, Olguita; Camacho-Moreno, German; Gomez, Virgen; Viviani, Tamara; Alvarez-Olmos, Martha, I; de Souza Marques, Heloisa Helena; Faugier-Fuentes, Enrique; Saltigeral-Simental, Patricia; Lopez-Medina, Eduardo; Mino-Leon, Greta; Beltran, Sandra; Martinez-Medina, Lucila; Pirez, Maria C.; Cofre, Fernanda; Tremoulet, Adriana H.
    Objective:To characterize the clinical presentation and outcomes of Kawasaki disease (KD) in infants Methods:We evaluated 36 infants <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. Results: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 <6 months. Clinical features of KD were more commonly observed in the older cohort: oral changes (92 vs. 75%,P= 0.0023), extremity changes (74.6 vs. 57.1%,P= 0.029), and cervical lymphadenopathy (67.6 vs. 37.1%,P= 0.0004). Whether treated in the first 10 days of illness or after the 10th day, infants <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%,P= 0.00012); >10 days (50 vs. 7.4%,P= 0.043)]. Conclusion:Our data show that despite treatment in the first 10 days of illness, infants <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.