2026-04-29T07:24:20Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/227932025-04-30T11:13:33Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16938col_20.500.12105_16967

00925njm 22002777a 4500 dc Fernandez-Cooke, Elisa author Barrios Tascon, Ana author Sanchez-Manubens, Judith author Anton, Jordi author Grasa Lozano, Carlos Daniel author Aracil Santos, Javier author Villalobos Pinto, Enrique author Clemente Garulo, Daniel author Mercader Rodriguez, Beatriz author Bustillo Alonso, Matilde author Nuñez Cuadros, Esmeralda author Navarro Gómez, María Luisa author Dominguez-Rodriguez, Sara author Calvo, Cristina author KAWA-RACE study group author 2019-05-20 Background: 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. Objective: 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. Methods: 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). Results 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<0.001). A total of 97% of the patients received intravenous immunoglobulin (IVIG) with a median number of days from fever onset to IVIG administration of 7.2. A second dose was given to 15.7% and steroids to 14.5% patients. Only 1.4% patients received infliximab. No deaths were reported. A multivariate analysis identified anemia, hypoalbuminemia, hyponatremia, higher creatinine and procalcitonin as independent risk factors for treatment failure and length under 103 cm, hemoglobin < 10.2 mg/dL, platelets > 900,000 cells/mm(3), maximum temperature < 39.5 degrees C, total duration of fever > 10 days and fever before treatment >= 8 days as independent risk factors for developing coronary aneurysms. Conclusions: 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. Fernandez-Cooke E, Barrios Tascon A, Sanchez-Manubens J, Anton J, Grasa Lozano CD, Aracil Santos J, et al. Epidemiological and clinical features of Kawasaki disease in Spain over 5 years and risk factors for aneurysm development. (2011-2016): KAWA-RACE study group. PLoS One. 2019 May 20;14(5):e0215665. 1932-6203 http://hdl.handle.net/20.500.13003/16953 https://hdl.handle.net/20.500.12105/22793 31107862 10.1371/journal.pone.0215665 PloS One 2-s2.0-85066078730 468285200002 L2002007980 Epidemiological and clinical features of Kawasaki disease in Spain over 5 years and risk factors for aneurysm development. (2011-2016): KAWA-RACE study group