Kawasaki disease in adolescence

Abstract

Currently a large number of patients are waiting for organ transplantation and newborns with anencephaly are thought to be potential candidates for organ transplantation A male baby was born to a 30 year old mother after 38 weeks of gestation with a birth weight of 2430 g Antenatal ultrasonography performed during the last months of the pregnancy revealed the presence of anencephaly The parents were asked for organ donation from the infant and informed consent was obtained The infant died at the 24th hours of his life Therefore the diagnosis of the brain death which required two clinical examinations and two electroencephalographic examinations with an interval of 48 hours could not be achieved It is not a practical approach in such cases to make a diagnosis of brain death with electroencephalography Therefore new approaches should be developed for anencephalic newborns Ethical and legal issues on this subject are still controversial Here we present the challenges posed by this case and also discuss the difficulty involved in choosing anencephalic neonates as candidate organ donors Turk Arch Ped 2013; 48: 165 8

Keywords

• Adolescent Kawasaki disease, coronary artery dilatation, pulmonary involvement

Ergenlikte Kawasaki hastalığı

Öz

Kawasaki hastalığı erken çocukluk döneminde görülen koroner arter tutulumu nedeniyle hastalık ve ölüme yol açan bir vaskülittir Büyük çocuk ve ergenlerde nadir görülmesi tanının gecikmesine neden olarak koroner arter tutulumu için bir risk etmeni oluşturabilir Kliniğimizde ergen yaşta Kawasaki hastalığı tanısı koyduğumuz koroner arter genişlemesi ve akciğer tutulumu da gözlenen bir olgumuzu sunuyoruz.

Anahtar Kelimeler

• Akciğer tutulumu
• erişkin Kawasaki hastalığı
• koroner arter genişlemesi

References

1. Newbuger JW, Takahashi M, Gerber MA, 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(17): 2747-71.
2. Masato T, Newburger JW. Kawasaki syndrome (mucocutaeous lymph node syndrome). Moss and Adam’s heart disease in infants, children, and adolescents. 7th edition. Philadelphia: Lippincott Williams & Wilkins (LWW) 2008; 61: 1242-56.
3. Hara T, Mizuno Y, Akeda H, et al. Thrombocytopenia: a complication of Kawasaki disease. Eur J Pediatr 1988; 147(1): 51-3.
4. Stockheim JA, Innocentini N, Shulman ST. Kawasaki disease in older children and adolescents. J Pediatr 2000; 137(2): 250-2.
5. Sève P, Stankovic K, Smail A, Durand DV, Marchand G, Broussolle C. Adult Kawasaki disease: report of two cases and literature review. Semin Arthritis Rheum 2005; 34(6): 785-92.
6. Uziel Y, Hashkes PJ, Kassem E, Gottesman G, Wolach B. ‘Unresolving pneumonia” as the main manifestation of atypical Kawasaki disease. Arch Dis Child 2003; 88(10): 940-2.
7. Sengler C, Gaedicke G, Wahn U, Keitzer R. Pulmonary symptoms in Kawasaki disease. Pediatr Infect Dis J 2004; 23(8): 782-4.
8. Hyun JK, Soo JL. Two cases of Kawasaki disease following pneumonia. Korean J Pediatr 2009; 52(5): 615-8.

9. Umezawa T, Saji T, Matsuo N, Odagiri K. Cheest X-ray findings in the acute phase of Kawasaki disease. Pediatr Radiol 1989; 20(1-2): 48-51.
10. Dajani AS, Taubert KA, Gerber MA, et al. Diagnosis and therapy of Kawasaki disease in children. Circulation 1993; 87(5): 1776-80. Tsuda E, Kamiya T, Ono Y, Kimura K, Kurosaki K, Echigo S. Incidence of stenotic lesions predicted by acute phase changes in coronary arterial diameter during Kawasaki disease. Pediatr Cardiol 2005; 26(1): 73-9.
11. Tsuda E, Kamiya T, Ono Y, Kimura K, Echigo S. Dilated coronary arterial lesions in the late period after Kawasaki disease. Heart 2005; 91(2): 177-82.
12. Kato H, Sugimura T, Akagi T, et al. Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation 1996; 94(6): 1379-85.