Research Article
Year 2021,
Volume: 4 Issue: 1, 1 - 7, 30.04.2021
Abstract
ÖZET
Amaç: Kawasaki hastalığı çocukluk çağının en yaygın vaskülitlerinden biridir. Bu çalışmada son 10 yılda pediatri kliniğinde Kawasaki hastalığı tanısı alan hastaların geriye dönük olarak değerlendirilmesi amaçlanmıştır.
Materyal-Metod: Bu çalışmada, 2007-2017 yılları arasında tanı kriterlerine göre Kawasaki hastalığı tanısı almış olan 44 olgunun demografik ve klinik özellikleri, ekokardiyografi bulguları ve laboratuvar bulguları, tedavi ve izlem sonuçları dosya kayıtlarından geriye dönük olarak incelendi.
Sonuçlar: Çalışmaya 24 (54%) erkek, 20 (%46) kız olmak üzere toplam 44 olgu dâhil edildi. Tanı esnasında hastaların ortalama yaşı 49,2±31,4 (7-160) aydı. Ortalama ateş süresi 8,1±2,1gün iken ortalama hastane yatış süresi 8,4gün ±2,9 gün olarak tespit edildi. Tanı alan olguların 36 (%81) komplet Kawasaki hastalığı, 8 (%19) hasta inkomplet Kawasaki hastalığı olarak değerlendirildi. Bazı olgularda serum sodyum, albümin ve/veya D vitamini düzeyi düşüklüğü ve/veya sterilpiyüri saptandı. Olguların hepsine yüksek doz intravenöz immünoglobulin (2 g/kg) ve antienflamatuvar dozda aspirin (80-100 mg/kg/gün) başlandı. İki olguya IVIG sonrası ateşin devam etmesi üzerine tekrarlayan intravenöz immünoglobulin infüzyonu verildi. Olguların tamamında klinik ve laboratuar bulguları tedavi ile düzelirken yalnızca bir olguda rekurrens gelişti.
Tartışma: Kawasaki hastalığının erken dönemde tanı alması, bu hastalığa bağlı gelişebilecek ciddi komplikasyonları önleme açısından oldukça önemlidir. Hiponatremi, hipoalbüminemi, artmış serum transaminaz düzeyleri ve/veya steril piyüri varlığının Kawasaki hastalığıtanısını destekleyen laboratuvar bulguları olduğu düşünüldü.
Keywords
References
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Year 2021,
Volume: 4 Issue: 1, 1 - 7, 30.04.2021
Abstract
References
- 1. Jamieson N, Singh-Grewal D. Kawasaki Disease: A Clinician’s Update. Int J Pediatr 2013;2013:645391. doi: 10.1155/2013/645391. 2. Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Clinical observation of 50 patients. Jpn J Allergy 1967;16: 178-222. 3. Suzuki A, Kamiya T, Kuwahara N et al. Coronary arterial lesions of Kawasaki disease: cardiac catheterization findings of 1,100 cases. Pediatr Cardiol 1986;7:3–9. 4. Kato H, Sugimura T, Akagi T, et al. Long-term consequences of Kawasaki disease: 10–21-year follow-upstudy of 594 patients. Circulation1996; 94:1379–85. 5. deGraeff N, Groot N, Ozen S, et al. European consensus-based recommendations for the diagnosis and treatment of Kawasaki disease - the SHARE initiative, Rheumatology (Oxford) 2019;58:672-82. 6. McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation 2017;135:e927-99. 7. Onouchi Y. The genetics of Kawasaki disease. Int J Rheum Dis 2018;21:26-30. 8. Ozdemir H, Ciftçi E, Tapisiz A, Ince E, Tutar E, Atalay S, Dogru U Clinical and epidemiological characteristics of children with Kawasaki disease in Turkey. J Trop Pediatr 2010;56:260-2. 9. Tremoulet AH, Best BM, Song S, et al. Resistance to intravenous immunoglobulin in children with Kawasaki disease. J Pediatr 2008;153:117-21. 10. Nakamura Y, Yashiro M, Uehara R, et al. Epidemiologic features of Kawasaki disease in Japan: results of the 2007-2008 nationwide survey. J Epidemiol 2010; 20:302-7. 11. Fukushige J, Takahashi N, Ueda Y, Ueda K. Incidence and clinical features of incomplete Kawasaki disease. Acta Paediatr 1994; 83:1057-60. 12. Yeom JS, Woo HO, Park JS, et al. Kawasaki disease in infants. Korean J Pediatr 2013; 56:377-82. 13. Binnetoğlu K, Kuşdal Y, Altun G, BabaoğluK. Kocaeli Bölgesinde Kawasaki hastalığı tanısı alan 24 hastanın klinik ve epidemiyolojik özellikleri. Çocuk Enf Derg 2010;4: 71-5. 14. Ergüven M, Yasa O, Kral A, Bulut Ö. Kawasaki hastalığı tanısı almış hastalarımızda epidemiyolojik, klinik, laboratuvar, prognostik özelliklerinin ve ekokardiyografik bulgularının değerlendirilmesi. Çocuk Dergisi 2010;10:86-9. 15. Tsuji Y, Miller LL, Miller SC, Torti SV, Torti FM. Tumor necrosis factor-alpha and interleukin 1-alpha regulate transferin receptor in human diploid fibroblasts. Relationship to the induction of ferritin heavy chain. J Biol Chem. 1991;266:7257–61. 16. Yamamoto N, Sato K, Hoshina T, Kojiro M, Kusuhara K. Utility of ferritin as a predictor of the patients with Kawasaki disease refractory to intravenous immunoglobulin therapy. Mod Rheumatol 2015;25:898-902. 17. Kuo H.C.,Yang Y.L., Chuang J.H., Tiao M.M., Yu H.R., Huang L.T., Yang K.D., Chang W.C., Lee C.P., Huang Y.H. Inflammation-induced hepcidin is associated with the development of anemia and coronary artery lesions in Kawasaki disease. J Clin Immunol 2012;32:746–52. 18. Arora K, Guleria S, Jindal AK, Rawat A, Singh S. Platelets in Kawasaki disease: Is this only a numbers game or something beyond? Genes Dis. 2019;7:62-6. 19. TsujiS. Significance of hyponatremia in Kawasaki disease. Pediatr Int 2020;62:307. 20. Mammadov G, Liu HH, Chen WX, et al. Hepatic dysfunction secondary to Kawasaki disease: characteristics, etiology and predictive role in coronary artery abnormalities. Clin Exp Med 2020;20:21-30. 21. Liu L, Yin W, Wang R, Sun D, He X, Ding Y. Theprognostic role of abnormal liver function in IVIG unresponsiveness in Kawasaki disease: a meta-analysis. Inflamm Res 2016;65:161-8. 22. Vanherwegen AS, Gysemans C, Mathieu C. Regulation of Immune Function by Vitamin D andIts Use in Diseases of Immunity. Endocrinol Metab Clin North Am 2017;46:1061-94. 23. Stagi S, Rigante D, Lepri G, Matucci Cerinic M, Falcini F. Severe vitamin D deficiency in patients with Kawasaki disease: A potential role in the risk to develop heart vascular abnormalities? Clin Rheumatol 2016;35:1865–72. 24. Syal SK, Kapoor A, Bhatia E et al (2012) Vitamin D deficiency, coronary artery disease, and endothelial dysfunction: observations from a coronary angiographic study in Indian patients. J Invasive Cardiol 2012;24:385–9. 25. Watanabe T, Abe Y, Sato S, et al. Sterile pyuria in patients with Kawasaki disease originates from both the urethra and the kidney. Pediatr Nephrol 2007;22: 987-991. 26. Sepahi MA, Miri R, Ahmadi HT. Association of sterile pyuria and coronary artery aneurysm in Kawasaki syndrome. Act aMed Iran 2011;49:606–11. 27. Galeotti C, Kaveri SV, Bayry J. IVIG-mediated effector functions in autoimmune and inflammatorydiseases.IntImmunol. 2017;29(11):491-498. 28. Rowley AH, Shulman ST. The Epidemiology and Pathogenesis of Kawasaki Disease. Front Pediatr 2018;6:374. doi: 10.3389/fped.2018.00374. eCollection 2018.
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Details
| Primary Language | Turkish |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Original Investigation |
| Authors | |
| Publication Date | April 30, 2021 |
| Acceptance Date | December 22, 2020 |
| Published in Issue | Year 2021 Volume: 4 Issue: 1 |
