Cemsit KARAKURT, Damla INCE, Yilmaz TABEL, Ozlem ELKİRAN

Kawasaki Hastalığı: 15 Olgunun Değerlendirilmesi

Amaç: Kawasaki hastalığı genellikle 5 yaşın altında görülen, etyolojisi bilinmeyen orta küçük çaplı damarları etkileyen bir vaskülittir. Hastalığın en önemli morbidite ve mortalite nedeni koroner arter tutulumudur. Bu çalışmanın amacı 2011-2016 yılları arasında kliniğimizde takip edilmiş olan Kawasaki olgularının klinik ve labaratuvar özelliklerinin değerlendirilmesidir.Gereç ve Yöntem: Ocak 2011-Mayıs 2016 tarihleri arasında Kawasaki hastalığı nedeniyle kliniğimizde takip ve tedavisi yapılan 15 hastanın verileri geriye dönük olarak incelendi. Hastaların tanısı Amerikan Kalp Akademisinin Kawasaki hastalığı tanı kriterlerine göre konuldu.Bulgular: Çalışmamıza 15 tane hasta dahil edildi. Kawasaki hastalığının kriterlerinden ateş tüm olgularda görülen tek semptomdu. Bu hastaların içerisinde koroner arter tutulumu olan 1 hastamız vardı. Takiplerinde hastaların tümünde klinik ve labaratuvar bulgularnormale döndü, ek bir komplikasyon olmadı.Sonuç: Kawasaki hastalığı hastalığı genellikle 5 yaşın altında görülen, orta küçük çaplı damarları etkileyen bir vaskülittir. Tedavi edilmeyen hastaların % 25’inde koroner arter tutulumu bildirilmekle beraber hastalığın erken tanısı ve intravenöz immunoglobulinkullanımı ile bu oran % 5’e inmektedir. Tedaviye rağmen genetik yatkınlık nedeniyle dünyanın farklı bölgelerinde koroner arter tutulumu sıklığı farklı oranlarda bildirilmektedir. Ülkemizde Kawasaki hastalığının gerçek sıklığı bilinmemekle beraber bu çalışmada bölgemizde Kawasaki hastalığına bağlı koroner arter tutulumunun ülkemizden yapılan diğer yayınlara göre daha az olduğu saptanmıştır.

Kawasaki disease: evaluation of 15 cases

Objective: Kawasaki disease is characterized with acute systemic self–limited vasculitis, commonly affects middle and small size arteries, occurs predominantly in children under 5 years old age. Most common causes of morbidity and mortality in Kawasaki disease are coronary artery complications. Aim of this retrospective study is to evaluate clinical and laboratory results of 15 Kawasaki patients who were followed-up in 2011-2016 years. Materials and Methods: In this study the clinical and laboratory data of 15 Kawasaki disease patients, who were followed-up in January 2011- May 2016, were evaluated retrospectively. Diagnosis of Kawasaki disease was done according to the American Heart Association criteria. Results: Fever was most common clinical symptom and was seen in all patients. We observed coronary artery aneurysm only in one patient. During follow-up clinical and laboratory findings were improved and we did not determine any other complications. Conclusion: Kawasaki disease is characterized with acute systemic self – limited vasculitis, commonly affects middle and small size arteries, occurs predominantly in children under 5 years old age. Although coronary artery aneurysms was seen in 25% of untreated Kawasaki patients, the frequency of coronary artery aneurysm was decreased to 5% by using IVIG treatment. Despite the IVIG treatment, coronary aneurysms may be seen in different ratios in the gorups of Kawasaki patients due to genetic predisposition. Although we don’t have any information about the incidence of Kawasaki disease in our country, coronary artery aneurysms were seen lower in our patients than in other publications from our country.

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