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Kawasaki Hastalığı Olgularımızın Değerlendirilmesi

Year 2011, Volume: 5 Issue: 3, 149 - 155, 01.06.2011

Abstract

Giriş: Kawasaki hastalığı etyolojisi tam olarak bilinmeyen akut febril sistemik bir vaskülittir. Gelişmiş ülkelerde en sık edinsel kalp hastalığı nedenidir. Çalışmamızın amacı Kawasaki hastalığı tanısı alan hastalarımızın klinik farklılıklarını gözden geçirmektir.Metod: Aralık 2004 – Ocak 2009 tarihleri arasında hastanemizde Kawasaki hastalığı tanısı alıp, tedavi edilen hastaların demografik, klinik, laboratuvar ve tedavi sonuçları retrospektif olarak değerlendirildi.Bulgular: Kawasaki hastalığı tanısı alan 35 hastanın 10’u kız (% 28.6), 25’i erkek (%71.4) olup erkek/kız oranı 2.5, yaş ortancası 4 yıl olarak bulundu. Hastalarda ateşe en sık eşlik eden bulgular olarak deri döküntüsü (% 88.6) saptandı. Üç hastada (% 8.6) koroner arter anomalisi tespit edildi. Hastaların % 51.4’ü klasik, %48.6’sı inkomplet Kawasaki hastalığı tanısı aldı. Konjonktivit, orofarenks ve periferal ekstremite değişiklikleri klasik Kawasaki hastalığı grubunda daha yüksek oranda bulunmakla birlikte sadece periferal ekstremite değişiklikleri yönünden istatistiksel olarak anlamlı fark bulundu (p=0.041). Her iki grup arasında yaş, cinsiyet, ateş süresi, İVİG tedavisi alma zamanı, kan sayımı ve akut faz reaktanları yönünden bir fark gözlenmedi (p>0.05).Sonuç: Kawasaki hastalığında mortalite ve morbiditenin başlıca nedeni olan kardiyovasküler komplikasyonların önlenmesi için tanı ve tedavisinin zamanında yapılması önemlidir.

References

  • Kawasaki T. Acute febrile mucocutenous syndrome with lymphoid involvement with spesific desquamation of the fingers and toes in children. Arerugi 1967;16(3):178-222.
  • Luqmani RA, Robinson H. Introduction to, and classification of the systemic vasculitides. Best Pract Res Clin Rheumatol 2001;15(2):187-202.
  • Gardner-Medwin JM, Dolezolova P, Cummins C, Southwood TR. Incidence of Henoch-Schöenlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins. Lancet 2002;360(9341):1197-202.
  • Cimaz R, Falcini F. An update on Kawasaki disease. Auotoimmun Rev 2003;2(5):258-63.
  • Burns JC, Glode MP. Kawasaki syndrome. Lancet 2004;364(9433):533-44.
  • Yoskowitch A, Tewfik TL, Duffy CM, Moroz B. Head and neck manifestations of Kawasaki disease. Int J Pediatr Otorhinolaryngol 2000;52(2):123-9.
  • Newburger J, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et.al. Diagnosis, treatment, and long term management of Kawasaki disease. A statement for health professionals from the committee on rheumatic fever, endocarditis, and Kawasaki disease, council on cardiovascular disease in the young. American Heart Association. Circulation 2004;110:2747-71.
  • Shingadia D, Bose A, Booy R. Could herpesvirus be the cause of Kawasaki disease? Lancet Infect Dis 2002;2(5):310-3.
  • Satou GM, Giamelli J, Gewitz MH. Kawasaki disease: diag- nosis, management, and long-term implications. Cardiol Rev 2007;15(4):163-9.
  • Ozdemir H, Ciftçi E, Tapisiz A, Ince E, Tutar E, Atalay S, et al. Clinical and Epidemiological Characteristics of Children with Ka- wasaki Disease in Turkey. J Trop Pediatr 2010;56(4):260-2.
  • Yavuz T, Nişli K, Öner N, Ömeroğlu RE, Dindar A, Aydoğan Ü, et al. Kawasaki hastalığı; 34 olgu sunumu. Türk Pediatri Arşivi 2006;41(4):197-200.
  • Baer AZ, Rubin LG, Shapiro CA, Sood SK, Rajan S, Shapir Y, et al. Prevalence of coronary artery lesions on the initial echo- cardiogram in Kawasaki syndrome. Arch Pediatr Adolesc Med 2006;160(7):686-90.
  • Tseng CF, Fu YC, Fu LS, Betau H, Chi CS. Clinical spec- trum of Kawasaki disease in infants. Zhonghua Yi Xue Za Zhi 2001;64(3):168-73.
  • Joffe A, Kabani A, Jadavji T. Atypical and complicated Ka- wasaki disease in infants. Do we need criteria? West J Med 1995;162(4):322-7.
  • Sonobe T, Kiyosawa N, Tsuchiya K, Aso S, Imada Y, Imai Y, et al. Prevalence of coronary artery abnormality in incomplete Kawasaki disease. Pediatr Int 2007;49(4):421-6.
  • Perrin L, Letierce A, Guitton C, Tran TA, Lambert V, Koné-Paut I. Comparative study of complete versus incomplete Kawasaki dis- ease in 59 pediatric patients. Joint Bone Spine 2009;76(5):481-5.
  • Lang B, Duffy CM. Controversies in the management of Kawasaki disease. Best Pract Res Clin Rheumatol 2002;16(3):427-42.
  • Vijayan AP, Dinesh KB, Dıvıa Nath KR. Coronary artery dilatation in incomplete Kawasaki disease. Indian Pediatr 2009;46(7):607-9.
  • Kurotobi S, Toshisaburo N, Kawakami N, Sano T. Coronary di- ameter in normal infants, children and patients with Kawasaki disease. Pediatr Int 2002:44(1);1-4.
  • Royle J, Burgner D, Curtis N. The diagnosis and management of Kawasaki disease. J Paediatr Child Health. 2005;41(3):87-93.
  • Pinna GS, Kafetzis DA, Tselkas OI, Skevaki CL. Kawasaki dis- ease: an overview. Curr Opin Infect Dis 2008;21(3):263-70.
  • Du ZD, Di Z, Du JB, Lu S, Yi JM, Hou AC, et al. Comparison of efficacy among early, conventional and late intravenous gamma globulin treatment of Kawasaki disease. Zhonghua Yi Xue Za Zhi 2009;89(26):1841-3.
  • Fukazawa R, Ogawa S. Long term prognosis of patients with Ka- wasaki disease: at risk for future atherosclerosis? J Nippon Med Sch 2009;76(3):124-33.
  • Senzaki H. Long-term outcome of Kawasaki disease. Circulation 2008;118(25):2763-72.

EVALUATION OF CHILDREN WITH KAWASAKI DISEASE

Year 2011, Volume: 5 Issue: 3, 149 - 155, 01.06.2011

Abstract

Background: Kawasaki disease (KD) is a febrile systemic vasculitis of childhood and its etiology remains unknown. The leading cause of KD is acquired heart disease in developed countries. The aim of this study is to describe clinical and epidemiological characteristics of children with Kawasaki disease in our hospital.Material and method: Between December 2004 and January 2009; the medical records of the patients treated for KD at Dr. Sami Ulus Children’s Training and Research Hospital were reviewed retrospectively fort this study.Results: Thirty five patients were diagnosed as having Kawasaki disease in our center. Male to female ratio was 2.5. The median age at diagnosis was 4 years. Skin rash (88.6%) was the leading accompying finding to fever. Coronary artery anomaly was detected in 3 (8.6%) patients. Classical KD and incomplete KD was found in 51.4% and 48.6% of the patients, respectively. Although conjunctivitis, oropharyngeal and peripheral extremity findings were more common in the classical KD group, the difference was statistically significant for only peripheral extremity findings between classical and incomplete KD groups (p=0.041). Age, gender, duration of fever, time for IVIG treatment, and laboratory findings were not different between two groups (p>0.05). Conclusion: Early diagnosis and appropriate treatment of KD is important in terms of avoiding the cardiovascular complications; the leading cause of mortality and morbidity

References

  • Kawasaki T. Acute febrile mucocutenous syndrome with lymphoid involvement with spesific desquamation of the fingers and toes in children. Arerugi 1967;16(3):178-222.
  • Luqmani RA, Robinson H. Introduction to, and classification of the systemic vasculitides. Best Pract Res Clin Rheumatol 2001;15(2):187-202.
  • Gardner-Medwin JM, Dolezolova P, Cummins C, Southwood TR. Incidence of Henoch-Schöenlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins. Lancet 2002;360(9341):1197-202.
  • Cimaz R, Falcini F. An update on Kawasaki disease. Auotoimmun Rev 2003;2(5):258-63.
  • Burns JC, Glode MP. Kawasaki syndrome. Lancet 2004;364(9433):533-44.
  • Yoskowitch A, Tewfik TL, Duffy CM, Moroz B. Head and neck manifestations of Kawasaki disease. Int J Pediatr Otorhinolaryngol 2000;52(2):123-9.
  • Newburger J, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et.al. Diagnosis, treatment, and long term management of Kawasaki disease. A statement for health professionals from the committee on rheumatic fever, endocarditis, and Kawasaki disease, council on cardiovascular disease in the young. American Heart Association. Circulation 2004;110:2747-71.
  • Shingadia D, Bose A, Booy R. Could herpesvirus be the cause of Kawasaki disease? Lancet Infect Dis 2002;2(5):310-3.
  • Satou GM, Giamelli J, Gewitz MH. Kawasaki disease: diag- nosis, management, and long-term implications. Cardiol Rev 2007;15(4):163-9.
  • Ozdemir H, Ciftçi E, Tapisiz A, Ince E, Tutar E, Atalay S, et al. Clinical and Epidemiological Characteristics of Children with Ka- wasaki Disease in Turkey. J Trop Pediatr 2010;56(4):260-2.
  • Yavuz T, Nişli K, Öner N, Ömeroğlu RE, Dindar A, Aydoğan Ü, et al. Kawasaki hastalığı; 34 olgu sunumu. Türk Pediatri Arşivi 2006;41(4):197-200.
  • Baer AZ, Rubin LG, Shapiro CA, Sood SK, Rajan S, Shapir Y, et al. Prevalence of coronary artery lesions on the initial echo- cardiogram in Kawasaki syndrome. Arch Pediatr Adolesc Med 2006;160(7):686-90.
  • Tseng CF, Fu YC, Fu LS, Betau H, Chi CS. Clinical spec- trum of Kawasaki disease in infants. Zhonghua Yi Xue Za Zhi 2001;64(3):168-73.
  • Joffe A, Kabani A, Jadavji T. Atypical and complicated Ka- wasaki disease in infants. Do we need criteria? West J Med 1995;162(4):322-7.
  • Sonobe T, Kiyosawa N, Tsuchiya K, Aso S, Imada Y, Imai Y, et al. Prevalence of coronary artery abnormality in incomplete Kawasaki disease. Pediatr Int 2007;49(4):421-6.
  • Perrin L, Letierce A, Guitton C, Tran TA, Lambert V, Koné-Paut I. Comparative study of complete versus incomplete Kawasaki dis- ease in 59 pediatric patients. Joint Bone Spine 2009;76(5):481-5.
  • Lang B, Duffy CM. Controversies in the management of Kawasaki disease. Best Pract Res Clin Rheumatol 2002;16(3):427-42.
  • Vijayan AP, Dinesh KB, Dıvıa Nath KR. Coronary artery dilatation in incomplete Kawasaki disease. Indian Pediatr 2009;46(7):607-9.
  • Kurotobi S, Toshisaburo N, Kawakami N, Sano T. Coronary di- ameter in normal infants, children and patients with Kawasaki disease. Pediatr Int 2002:44(1);1-4.
  • Royle J, Burgner D, Curtis N. The diagnosis and management of Kawasaki disease. J Paediatr Child Health. 2005;41(3):87-93.
  • Pinna GS, Kafetzis DA, Tselkas OI, Skevaki CL. Kawasaki dis- ease: an overview. Curr Opin Infect Dis 2008;21(3):263-70.
  • Du ZD, Di Z, Du JB, Lu S, Yi JM, Hou AC, et al. Comparison of efficacy among early, conventional and late intravenous gamma globulin treatment of Kawasaki disease. Zhonghua Yi Xue Za Zhi 2009;89(26):1841-3.
  • Fukazawa R, Ogawa S. Long term prognosis of patients with Ka- wasaki disease: at risk for future atherosclerosis? J Nippon Med Sch 2009;76(3):124-33.
  • Senzaki H. Long-term outcome of Kawasaki disease. Circulation 2008;118(25):2763-72.
There are 24 citations in total.

Details

Other ID JA47ZJ83JR
Journal Section Research Article
Authors

Utku Arman Örün This is me

Vehbi Doğan This is me

Selmin Karademir This is me

Burhan Öcal This is me

Gönül Tanır This is me

Publication Date June 1, 2011
Submission Date June 1, 2011
Published in Issue Year 2011 Volume: 5 Issue: 3

Cite

Vancouver Örün UA, Doğan V, Karademir S, Öcal B, Tanır G. EVALUATION OF CHILDREN WITH KAWASAKI DISEASE. Türkiye Çocuk Hast Derg. 2011;5(3):149-55.


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