Previous or coincident infections with suspected Kawasaki disease. Should we change our approach?
Por:
Fernández-Cooke E, Barrios Tascón A, Antón-López J, Grasa Lozano CD, Sánchez-Manubens J and Calvo-Benet C
Publicada:
1 abr 2019
Ahead of Print:
1 ago 2018
Categoría:
Pediatrics, perinatology and child health
Resumen:
Introduction: Kawasaki disease (KD) is a multisystem vasculitis associated with coronary artery abnormalities. Infections could be a trigger of the inflammation. The main aim of this study was to describe the presence of infections in children with KD, and to analyse the clinical characteristics and the presence of coronary abnormalities in these cases.
Patients and methods: A retrospective study was performed within the Kawasaki Diseases Network (KAWA-RACE (2011-2016). An analysis was performed that included patients with positive microbiological findings (PMF) during the acute phase, as well as those with a previous recent infection (PRI) during the 4 weeks preceding KD diagnosis.
Results: The study included total of 621 children with KD, with PMF being found in 101 (16.3%) patients, and a PRI in 107 (17.2%). Significantly less echocardiographic abnormalities were found in the in the group with a PRI, when compared to those without a PRI (23 vs. 35%, P=.01) and also a lower proportion of overall coronary artery lesions (16 vs. 25%, P=.054). No significant differences were found in the proportion of aneurysms in either of these groups (PRI or PMF) when compared to those without infection.
Conclusions: In the present study, no differences were found in the incidence of coronary aneurysms in either of the groups, with or without PRI or PMF. Therefore, if KD is suspected, appropriate treatment should be started despite having a confirmed infection. (c) 2018 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U.
Filiaciones:
Fernández-Cooke E:
Servicio de Pediatría, Hospital 12 de Octubre, Madrid, España
Barrios Tascón A:
Servicio de Pediatría, Hospital Infanta Sofía, San Sebastián de los Reyes (Madrid), España
Antón-López J:
Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat (Barcelona), España
Grasa Lozano CD:
Servicio de Pediatría, Hospital 12 de Octubre, Madrid, España
Sánchez-Manubens J:
Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat (Barcelona), España
Calvo-Benet C:
Servicio de Pediatría, Hospital Universitario La Paz, Madrid, España
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