KAWASAKİ HASTALIĞI : İKİ OLGU SUNUMU

Year 2005, Volume: 6 Issue: 1, 39 - 42, 01.04.2005

S. Ayvaz Aydoğdu Tolga Ünüvar Ertürk Levent Gülten İnan

Abstract

Kawasaki hastalığı sistemik bir vaskülittir. En çok orta boy arterleri tutar. Gelişmiş ülkelerde çocuklarda edinselkalp hastalıklarının en sık nedenidir. Halen etiolojisi ve patogenezi tam aydınlatılmamıştır. Koroner arteretkilenmesine bağlı ani ölüm ve kronik hastalık riski intravenöz immünglobulin tedavisi sonrası belirginazalmaktadır. Bu nedenle erken ve doğru tanı prognoz açısından çok önemlidir.Kawasaki hastalığı tanısı konan iki olgumuzun birinde ekokardiyogramda sol ana koroner arterde dilatasyonsaptandı. Diğer olguda kardiyak lezyon yoktu. Koroner arter ektazisi izlemde geriledi. Bu makalede, iki olgunedeniyle Kawasaki hastalığı'nın tanısı, tedavi ve izlem ilkeleri tartışılmıştır

Keywords

Kawasaki hastalığı, IVIG, koroner anevrizma

Kawasaki Disease: Report of Two Cases

Abstract

Kawasaki disease is a systemic vasculitis. It affects medium-sized arteries most commonly. In developed countries, it is the most common reason for acquired cardiac diseases in children. Etiology and pathogenesis of the disease have not yet been completely clarified. Risk of sudden death or chronic cardiac disease due to coronary artery lesions are highly decreased after intravenous immunoglobulin therapy. Thus, early and correct diagnosis is of utmost importance for favorable outcome. In one of the two cases with Kawasaki disease, left main coronary artery was dilated on the echocardiogram. The other patient had no cardiac lesion. Coronary artery ectasia was observed to be regressed. In this paper, due to the two cases, diagnosis, treatment and follow-up principles of Kawasaki disease were discussed.

Keywords

Kawasaki disease, IVIG, coronary aneurysm

References

• 1. Shulman ST, RowleyAH. Etiology and pathogenesis of Kawasaki disease. Prog Pediatr Cardiol 1997;(6)3:187- 92
• 2. Mason WH, Burns JC. Clinical presentation of Kawasaki disease. Prog Pediatr Cardiol 1997;(6)3:193- 201
• 3. Fukushige N, Takahashi N, Ueda K, Ueda Y. Incidence and clinical features of incomplete Kawasaki Disease. Acta Paediatr 1994;83:105760.
• 4. Newburger JW, Takahashi M, Beiser AS et al. A single intravenous infusion of gamma globulin as compared with four infusions in the treatment of acute Kawasaki syndrome. N Engl J Med 1991;324:16339.
• 5. Kasapçopur Ö, Beker DB, Çalışkan S, Batmaz G, Çelebi A, Taştan Y, Balgöz P, Sever L, Arısoy N. Kawasaki Sendromu Türk Pediatri Arşivi 2000;35(3):160-3
• 6. Özyürek AR , Ülger Z, Levent E, Gürses D. Kawasaki hastalığı: 11 vakanın değerlendirilmesi. Çocuk Sağlığı ve Hastalıkları Dergisi 2004;47(3):172-7
• 7. Tan TH, Wong KY, Cheng TK, Heng JT.Coronary normograms and the coronary-aorta index: objective determinants of coronary artery dilatation. Pediatr Cardiol 2003 ;24(4):328-35.
• 8. Kusakawa S, Tatara K. Efficacies and risks of aspirin in the treatment of the Kawasaki disease. Prog Clin Biol Res 1987;250:40113.
• 9. Dajani AS, Taubert KA, Gerber MA, Shulman ST, Ferrieri P, Freed M, Takahashi M, Bierman FZ, Karchmer AW, Wilson W. Diagnosis and therapy of Kawasaki disease in children. Circulation 1993;87:177680.
• 10. Wright DA, Newburger JW, Baker A, Sundel RP. Treatment of immune globulin-resistant Kawasaki disease with pulsed doses of corticosteroids. J Pediatr 1996;128:146-9.
• 11. Furukawa S, Matsubara T, Umezawa Y, Motohashi T, Ino T,Yabuta K. Pentoxifylline and intravenous gamma globulin combination therapy for acute Kawasaki disease. Eur J Pediatr 1994;153: 6637.
• 12. Takahashi M, Mason WH. Long-term follow-up of patients with Kawasaki disease. Prog Pediatr Cardiol 1997;(6)3:227-36