Adölesan Olguda Kawasaki Hastalığı

Öz

Kawasaki hastalığı, sıklıkla 5 yaş altındaki çocukları etkileyen, koroner arter anomalisi gelişme riski taşıyan küçük-orta damar vaskülitidir. En az 5 gündür devam eden ateşten birkaç gün sonra diğer bulgular (eksudasız konjonktival hiperemi, eritemli orofarenks, çilek dili, çatlamış dudaklar, polimorfik, yaygın, eritematöz döküntü, eritemli el ayası ve ayak tabanı, tek taraflı, en az 1.5 cm çapında bir veya daha fazla servikal lenfadenopati) ortaya çıkar. Tedavide intravenöz immünglobulin ve yüksek doz asetil salisilik asit kullanılır. Bu olgu sunumunda Kawasaki hastalığının ilk 10 günü içinde sağlık güvencesinin olmaması nedeniyle intravenöz immünglobulin verilemeyen, bu nedenle yüksek doz asetil salisilik asit ve pulse metil prednizolon tercih edilen, ancak geç dönemde intravenöz immünglobulin tedavisi ile hastalığı kontrol altına alınabilen 12 yaşındaki bir kız hastanın klinik izlemi sunuldu.

Anahtar Kelimeler

• Kawasaki hastalığı, mukokutanöz lenf nodu sendromu, intravenöz immunoglobulin

ADOLESCENT CASE WITH KAWASAKI DISEASE

Öz

Kawasaki disease occurs predominantly in children younger than 5 years of age. The disease is a febrile, multisystem illness of importance because of the risk of development of coronary artery abnormalities. Kawasaki disease is a generalized systemic vasculitis involving small to medium blood vessels throughout the body. Within several days of the onset of fever (persisting for at least 5 days), other characteristic features of the illness usually appear, including conjunctival infection without exudates; erythematous mouth and pharynx, strawberry tongue, and red, cracked lips; a polymorphous, generalized, erythematous rash; erythematous palms and soles; a unilateral cervical lymph node enlarged to at least 1.5 cm in diameter. Treatment with intravenous immunoglobulin and high-dose acetyl salicylic acid remains the primary management strategy. We report a case of acute Kawasaki disease in a 12-year-old girl who could not be given intravenous immunoglobulin in the first 10 days of the illness because of social security problems. Although she was given high-dose aspirin and steroids in the acute phase, she was successfully treated with intravenous immunoglobulin in the subacute phase

Anahtar Kelimeler

• Kawasaki diseasemucocutaneous lymph node syndrome, intravenous immunoglobulin

Kaynakça

1. Satou GM, Giamelli J, Gewitz MH. Kawasaki disease: diag- nosis, management, and long-term implications. Cardiol Rev. 2007;15:163–169.
2. Rowley AH, Shulman ST. Kawasaki syndrome. Pediatr Clin North Am. 1999;46:313–329.
3. Stockheim JA, Innocentini N, Shulman ST. Kawasaki disease in older children and adolescents. J Pediatr. 2000;137:250–252.
4. Sève P, Stankovic K, Smail A, Durand DV, Marchand G, Brous- solle C. Adult Kawasaki disease: report of two cases and literature review. Semin Arthritis Rheum. 2005;34:785–792
5. Newburger JW, Taubert KA, Shulman ST, Rowley AH, Gewitz MH, Takahashi M, McCrindle BW. Summary and abstracts of the seventh International Kawasaki Disease Symposium: December 4-7, 2001. Pediatr Res. 2003;53:153–157.