Akut Pyelonefrit Kliniği İle Başvuran Bir Kawasaki Olgusu

Öz

Kawasaki hastalığı steril piyüri, mikroskopik hematüri ve proteinüri gibi idrar bulgularının sık görüldüğü bir sistemik vaskülittir. Bu olgu sunumunda, piyüri, ateş ve yüksek akut faz reaktanları nedeni ile antibiyotik tedavisi başlanan, izleminde Kawasaki hastalığı tanısı alarak IVIG tedavisi uygulanan ve tedavi ile koroner arterdeki perivasküler ekojenite artışı gerileyen beş yaşında bir erkek hasta sunuldu.

Anahtar Kelimeler

• Steril piyüri, kawasaki hastalığı

CLINICAL PRESENTATION WITH ACUTE PYELONEPHRITIS IN A CASE WITH KAWASAKI DISEASE

Öz

Kawasaki disease is a systemic vasculitis that often present with abnormal urinary findings, such as aseptic pyuria, mild proteinuria and microscopic haematuria. In this case report, we present a five-year-old boy who was initially prescribed antibiotics for pyuria, fever and high acute phase reactant levels, but later diagnosed as Kawasaki disease during the follow-up and regression of the coronary arterial perivascular echogenicity had been observed after IVIG treatment

Anahtar Kelimeler

• Sterile pyuria, kawasaki disease

Kaynakça

1. Watanabe T, Abe Y, Sato S, Uehara Y, Ikeno K, Abe T. Sterile pyu
2. ria in patients with Kawasaki disease orginates from both the ureth- ra and the kidney. Pediatr Nephrol 2007;22(7): 987-91.
3. Newburger JW, Takahashi M, Gerber MA, Gewitz MA, Gewitz MH, Tani LY, et al. Diagnosis, treatment, and long-term manage- ment of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Ka- wasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics 2004;114 (6):1708-33.
4. Burns JC. Kawasaki disease. Adv Pediatr 2001;48:157-77.
5. Wirojanan J, Sopontammark S, Vachvanichsanong P. Sterile pyuria in Kawasaki disease. Pediatr Nephrol 2004;19(3):363.
6. Melish ME. Kawasaki syndrome (the mucocutaneous lymph node syndrome). Pediatr Ann 1982;11(2):255-68.
7. Ohta K, Seno A, Shintani N, Kato E, Yachie A, Seki H,et al. Incre- ased levels of urinary interleukin-6 in Kawasaki disease. Eur J Pe- diatr 1993;152(8):647-9.
8. Wang JN, Chiou YY, Chiu NT, Chen MJ, Lee BF, Wu JM. Renal scarring sequelae in childhood Kawasaki disease. Pediatr Nephrol 2007;22(5): 684-9.

9. Shiono N, Koga Yasutsugu, Ito Hironobu, Egawa K, Ono S, Itami N. Really sterile pyuria with Kawasaki disease? Pediatr Nephrol 2004;19(1):124.
10. Jan SL, Wu MC, Lin MC, Fu YC, Chan SC, Lin SJ. Pyuria is not always sterile in children with Kawasaki disease. Pediatr Int 2010;52(1):113-7.
11. Shike H, Kanegaye JT, Best BM, Pancheri J, Burns JC. Pyuria as- sociated wıth acute Kawasaki Disease and fever from other cau- ses. Pediatr Infect Dis J 2009;28(5):440-3.
12. Salcedo JR, Greenberg L, Kapur S. Renal histology of mucocu- taneous lymph node syndrome (Kawasaki disease). Clin Nephrol 1988;29(1):47-51.
13. Veiga PA, Pieroni D, Baier W, Feld LG. Association of Ka- wasaki disease and interstistial nephritis. Pediatr Nephrology 1992;6(5):421-3.
14. Bonany PJ, Bilkis MD, Gallo G, Lago N, Dennenhy MV, Sosa del Valle JM,et al. Acute renal failure in Kawasaki disease. Pediatr Nephrol 2002;17(5):329-31.
15. Lee BW, Yap HK, Yip WC, Giam YC, Tay JS. Nephrotic syndrome in Kawasaki disease. Aust Pediatr J 1989;25(4):241-2.
16. Rowley AH, Shulmen ST, Mask CA, Finn LS, Terai M, Baker SC,et al. IgA plasma cell infiltration of proximal respiratory tract, pancreas, kidney, and coronary artery in acute Kawasaki disease. J Infect Dis 2000;182(4):1183-91.
17. Ferriero DM, Wolfsdorf JI. Hemolytic uremic syndrome associated with Kawasaki disease. Pediatrics 1981;68(3):405-6.
18. Nardi PM, Haller JO, Friedman AP, Slovis TL, Schaffer RM . Renal manifestations of Kawasaki’s disease. Pediatr Radiol 1985;15(2):116-8.
19. Papadodima SA, Sakelliadis EI, Goutas ND, Vlachodimitropoulos DG, Spiliopoulou CA. Atypical kawasaki disease presenting with symptoms from the genitourinary system: an autopsy report. J Trop Pediatr 2009;55(1):55-7.
20. Ristoska-Bojkovska N, Stavric K, Tasic V. Kawasaki disease misdi- agnosed as acute pyelonephritis. Pediatr Nephrol 2003;18(8):851- 2.
21. Wu CY, Hsieh KS, Chiou YH, Wang RS, Huang IF, Lee WY, et al. Prolonged fever and pyuria: a urinary tract infection presentation of incomplete Kawasaki disease. Acta Paediatr 2005;94(3):375-7.