Case report
Takayasu's Arteritis in the Newborn: A Diagnosis to Suspect
Arteritis de Takayasu en el recién nacido, un diagnóstico que sospechar
Gabriel Vega-Cornejo
, Jigal Meza-Beltrán
Corresponding author
Servicio de Reumatología Pediátrica, Hospital General de Occidente, Guadalajara, Mexico
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"documento" => "simple-article" "subdocumento" => "crp" "cita" => "Reumatol Clin. 2015;11:170-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1742 "formatos" => array:3 [ "EPUB" => 63 "HTML" => 1335 "PDF" => 344 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Ocular Toxicity and Functional Vision Recovery in A patient Treated With Hydroxychloroquine" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "170" "paginaFinal" => "173" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Toxicidad ocular y recuperación visual funcional en una paciente tratada con hidroxicloroquina" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 3376 "Ancho" => 2334 "Tamanyo" => 481368 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Central multifocal electroretinogram of both eyes of the patient. (A) At the time of diagnosis. (B) One year after cessation of treatment with hydroxychloroquine. Note the normalization of the waves and its graphical representation in the color scale.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Francisco Jorge Rodríguez-Hurtado, José Antonio Sáez-Moreno, José Manuel Rodríguez-Ferrer" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Francisco Jorge" "apellidos" => "Rodríguez-Hurtado" ] 1 => array:2 [ "nombre" => "José Antonio" "apellidos" => "Sáez-Moreno" ] 2 => array:2 [ "nombre" => "José Manuel" "apellidos" => "Rodríguez-Ferrer" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1699258X14001296" "doi" => "10.1016/j.reuma.2014.06.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14001296?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314001440?idApp=UINPBA00004M" "url" => "/21735743/0000001100000003/v2_201505050301/S2173574314001440/v2_201505050301/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Takayasu's Arteritis in the Newborn: A Diagnosis to Suspect" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "174" "paginaFinal" => "176" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Gabriel Vega-Cornejo, Jigal Meza-Beltrán" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Gabriel" "apellidos" => "Vega-Cornejo" "email" => array:1 [ 0 => "gvc81@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Jigal" "apellidos" => "Meza-Beltrán" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Reumatología Pediátrica, Hospital General de Occidente, Guadalajara, Mexico" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Arteritis de Takayasu en el recién nacido, un diagnóstico que sospechar" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 909 "Ancho" => 801 "Tamanyo" => 84934 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The presence of aneurysms at the descending and abdominal aorta level can be seen.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Takayasu's arteritis is a large vessel vasculitis that mainly affects the aorta, its major branches and the pulmonary arteries. It may present segmental stenosis, occlusion, dilatation or aneurysm formation during the course of the disease.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> An incidence of 2.6/1<span class="elsevierStyleHsp" style=""></span>000<span class="elsevierStyleHsp" style=""></span>000 cases per year in North America is estimated, however, no information is available on the incidence of TA in the pediatric age.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">All major arteries can be affected, but the vessels most commonly involved are the aorta, subclavian and carotid (60%–90%). It presents various signs and symptoms such as malaise, joint pain, claudication, lightheadedness, heart murmurs, absent or diminished pulses and loss of blood pressure.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Clinical Observation</span><p id="par0015" class="elsevierStylePara elsevierViewall">The patient had been hospitalized at birth for suspected trisomy 21, symptomatic hypoglycemia, apnea, intrauterine pneumonia and septic shock. During the hospital stay, a diagnosis of patent ductus arteriosus (PDA) was performed, accompanied by hemodynamic consequences and <span class="elsevierStyleItalic">Enterobacter cloacae</span> bacteremia.</p><p id="par0020" class="elsevierStylePara elsevierViewall">While performing the first echodopplercardiogram, a dilated descending aorta was observed, corroborated by a postsurgical repair of the PDA echocardiography, with an aneurysm of the aortic arch distal to the subclavian artery and the presence of thrombus 4<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>cm at the mouth of superior vena cava; an angiotomography demonstrated an aortic aneurism, a probable aortic coarctation, plus an abdominal aortic aneurysm (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). At diagnosis, the patient had a normal platelet and white blood cell count, anemia, hypocomplementemia at the expense of C3, increased factor <span class="elsevierStyleSmallCaps">VIII</span> and positive PCR.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">When approaching the diagnosis, an infectious etiology which may predispose to the inflammatory condition that causes vasculitis is sought; we determined anti-rubella, toxoplasma, CMV, Herpes type 1 and 2 antibodies, <span class="elsevierStyleItalic">Aspergillus fumigatus</span> IgE, IgA <span class="elsevierStyleItalic">Candida albicans</span>, IgG and IgM, Anti Epstein–Barr virus capsid antigen IgG and IgM, Hepatitis B, Hepatitis C and HIV, all of which were negative.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Management began with immunoglobulin 2<span class="elsevierStyleHsp" style=""></span>g/kg/d and prednisone 2<span class="elsevierStyleHsp" style=""></span>mg/kg/day plus anticoagulation with enoxaparin and warfarin for maintenance at 0.3<span class="elsevierStyleHsp" style=""></span>mg/kg/day due to the presence of thrombus in the aforementioned lesion, as well as due to prothrombotic factors and a high cardiovascular risk; no treatment with cyclophosphamide was initiated because of the patient's age and the infection at the time of diagnosis.</p><p id="par0035" class="elsevierStylePara elsevierViewall">We do not know how the patient evolved as the patient was transferred to another hospital for administrative reasons.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">TA represents 1.5% of vasculitis in childhood; 2% of cases are diagnosed before 10 years of age. The course is variable, depending on the degree of activity, time of diagnosis, presentation and associated symptoms and the effect on other organs. It may have multiple relapses despite treatment. The inflammatory process causes thrombosis in the affected arteries, gradual emergence of stenosis, dilation and aneurysms.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">When control echocardiograms were performed for the underlying cardiac disease, aortic dilatation was noted, being more evident in the 3rd week of life; because of this finding, we opted to confirm it through a CT angiography (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>)</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">The criteria for classification of AT were established by the American College of Rheumatology (ACR) in 1990, having over 90% sensitivity and specificity. The lack of a control group with atherosclerotic aortic or congenital disease may limit its usefulness, especially in the pediatric age.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The patient presented decreased distal pulses, predominantly in the left lower limb, with a difference greater than 10<span class="elsevierStyleHsp" style=""></span>mmHg in the BP on the 4 limbs and angiographic changes in the aorta. The diagnosis of Takayasu's arteritis is integrated, according to the ACR, when 4 criteria are present, representing a sensitivity of 90.5% and specificity of 97.8%.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a> According to the radiological classification proposed in 1994 by the ACR the patient had thoracic and abdominal artery lesions, type <span class="elsevierStyleSmallCaps">III</span> according to the classification.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> According to the criteria for vasculitis in childhood proposed in 2005 by Ozen et al.,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> which include angiographic changes (CT or conventional MRI) of the aorta or its major branches as a major criterion, and at least one of the following criteria: diminished peripheral arterial pulses and/or limb claudication, difference in BP>10<span class="elsevierStyleHsp" style=""></span>mmHg, dilation of aorta or its major branches and hypertension, with one major criterion and 3 minor ones making the diagnosis according with this classification.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusions</span><p id="par0060" class="elsevierStylePara elsevierViewall">While TA is not a common disease in the pediatric age, it should be taken into account in patients with diminished pulses, regardless of their status. Although in TA there is no direct relationship with the ongoing infectious process, the inflammatory pattern may predispose the patient, and the previously described histopathological finding of inflammation composed of plasma cells, lymphocytes and eosinophils in early stages of the disease has been identified.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a> Early diagnosis of this vasculitis, and the early onset of immunosuppressive therapy is critical to avoid complications.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a> The creation of criteria including pediatric and neonatal populations should be considered.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Ethical Responsibilities</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Protection of people and animals</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare this research did not perform experiments on humans or animals.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Data confidentiality</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their workplace regarding the publication of patient data.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Right to privacy and informed consent</span><p id="par0075" class="elsevierStylePara elsevierViewall">The authors have obtained the informed consent of patients and/or subjects referred to in the article. This document is in the possession of the corresponding author.</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conflict of Interest</span><p id="par0080" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres493495" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec515316" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres493494" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec515317" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinical Observation" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conclusions" ] 8 => array:3 [ "identificador" => "sec0025" "titulo" => "Ethical Responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Data confidentiality" ] 2 => array:2 [ "identificador" => "sec0040" "titulo" => "Right to privacy and informed consent" ] ] ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflict of Interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-02-12" "fechaAceptado" => "2014-06-06" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec515316" "palabras" => array:4 [ 0 => "Takayasu's arteritis" 1 => "Neonate" 2 => "Infection" 3 => "Vasculitis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec515317" "palabras" => array:4 [ 0 => "Takayasu" 1 => "Neonato" 2 => "Infección" 3 => "Vasculitis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Takayasu arteritis is a vasculitis that affects the aorta, and its large branches, including renal, coronary and pulmonary arteries. This is a case report of a newborn who had early onset sepsis, vascular imaging reported aneurysms in the thoracic and abdominal aorta, with decreased distal pulses, a blood pressure difference >10<span class="elsevierStyleHsp" style=""></span>mmHg and angiographic changes, integrating the diagnose of Takayasu's arteritis.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La arteritis de Takayasu es una vasculitis de grandes vasos, afecta principalmente a la aorta, a sus ramas principales, incluyendo las arterias renales, coronarias y pulmonares. Se reporta un caso de recién nacido hospitalizado desde su nacimiento por proceso séptico, en el cual se encuentran aneurismas a nivel de aorta descendente y abdominal. El paciente cursa con disminución de pulsos distales, predominio en extremidad inferior izquierda, discrepancia mayor a 10<span class="elsevierStyleHsp" style=""></span>mmHg en toma de TA en 4 extremidades, así como cambios angiográficos en aorta integrándose el diagnóstico de arteritis de Takayasu.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Vega-Cornejo G, Meza-Beltrán J. Arteritis de Takayasu en el recién nacido, un diagnóstico que sospechar. Reumatol Clin. 2015;11:174–176.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 909 "Ancho" => 801 "Tamanyo" => 84934 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The presence of aneurysms at the descending and abdominal aorta level can be seen.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 999 "Ancho" => 799 "Tamanyo" => 55213 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Descending aortic arch aneurysm.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Takayasu arteritis revisited: current diagnosis and treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "I. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 15 | 8 | 23 |
| 2024 October | 69 | 18 | 87 |
| 2024 September | 84 | 19 | 103 |
| 2024 August | 93 | 42 | 135 |
| 2024 July | 66 | 31 | 97 |
| 2024 June | 89 | 27 | 116 |
| 2024 May | 69 | 33 | 102 |
| 2024 April | 103 | 24 | 127 |
| 2024 March | 89 | 32 | 121 |
| 2024 February | 32 | 23 | 55 |
| 2024 January | 58 | 22 | 80 |
| 2023 December | 74 | 45 | 119 |
| 2023 November | 47 | 26 | 73 |
| 2023 October | 58 | 32 | 90 |
| 2023 September | 71 | 31 | 102 |
| 2023 August | 43 | 14 | 57 |
| 2023 July | 59 | 26 | 85 |
| 2023 June | 59 | 32 | 91 |
| 2023 May | 65 | 31 | 96 |
| 2023 April | 42 | 9 | 51 |
| 2023 March | 79 | 27 | 106 |
| 2023 February | 62 | 26 | 88 |
| 2023 January | 50 | 18 | 68 |
| 2022 December | 80 | 36 | 116 |
| 2022 November | 77 | 25 | 102 |
| 2022 October | 65 | 42 | 107 |
| 2022 September | 66 | 42 | 108 |
| 2022 August | 58 | 43 | 101 |
| 2022 July | 53 | 46 | 99 |
| 2022 June | 46 | 33 | 79 |
| 2022 May | 66 | 41 | 107 |
| 2022 April | 67 | 50 | 117 |
| 2022 March | 67 | 55 | 122 |
| 2022 February | 71 | 31 | 102 |
| 2022 January | 72 | 37 | 109 |
| 2021 December | 65 | 38 | 103 |
| 2021 November | 55 | 47 | 102 |
| 2021 October | 83 | 74 | 157 |
| 2021 September | 65 | 45 | 110 |
| 2021 August | 69 | 43 | 112 |
| 2021 July | 63 | 37 | 100 |
| 2021 June | 69 | 51 | 120 |
| 2021 May | 132 | 41 | 173 |
| 2021 April | 190 | 84 | 274 |
| 2021 March | 93 | 43 | 136 |
| 2021 February | 83 | 33 | 116 |
| 2021 January | 56 | 22 | 78 |
| 2020 December | 62 | 30 | 92 |
| 2020 November | 61 | 28 | 89 |
| 2020 October | 56 | 24 | 80 |
| 2020 September | 61 | 29 | 90 |
| 2020 August | 48 | 31 | 79 |
| 2020 July | 41 | 28 | 69 |
| 2020 June | 59 | 27 | 86 |
| 2020 May | 55 | 21 | 76 |
| 2020 April | 70 | 26 | 96 |
| 2020 March | 23 | 10 | 33 |
| 2020 February | 2 | 0 | 2 |
| 2020 January | 1 | 0 | 1 |
| 2018 May | 6 | 0 | 6 |
| 2018 April | 53 | 8 | 61 |
| 2018 March | 75 | 10 | 85 |
| 2018 February | 35 | 5 | 40 |
| 2018 January | 26 | 9 | 35 |
| 2017 December | 45 | 14 | 59 |
| 2017 November | 33 | 18 | 51 |
| 2017 October | 31 | 8 | 39 |
| 2017 September | 30 | 17 | 47 |
| 2017 August | 27 | 13 | 40 |
| 2017 July | 35 | 20 | 55 |
| 2017 June | 92 | 22 | 114 |
| 2017 May | 64 | 22 | 86 |
| 2017 April | 48 | 25 | 73 |
| 2017 March | 42 | 43 | 85 |
| 2017 February | 27 | 16 | 43 |
| 2017 January | 33 | 21 | 54 |
| 2016 December | 69 | 17 | 86 |
| 2016 November | 54 | 15 | 69 |
| 2016 October | 79 | 14 | 93 |
| 2016 September | 73 | 8 | 81 |
| 2016 August | 62 | 7 | 69 |
| 2016 July | 38 | 10 | 48 |
| 2015 December | 2 | 0 | 2 |
| 2015 November | 1 | 15 | 16 |
| 2015 October | 1 | 15 | 16 |
| 2015 September | 3 | 0 | 3 |
| 2015 August | 0 | 15 | 15 |
| 2015 July | 28 | 11 | 39 |
| 2015 June | 52 | 11 | 63 |
| 2015 May | 62 | 29 | 91 |
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