Sibel BOZABALI

Kawasaki Hastalığı: Olgularımızın Klinik ve Epidemiyolojik Özellikler

Amaç: Kawasaki Hastalığı (KH) tanısı ile izlenen olgularımızın tipik ve atipik klinik özelliklerinin tespit edilmesi amaçlanmıştır.Gereç ve Yöntemler: Ekim 2014 - Mayıs 2017 tarihleri arasında KH tanısıyla izlenen hastalar çalışmaya dahil edilmiştir.Hastaların tanısı American Heart Association (AHA) tanı kriterlerine göre konulmuştur.Bulgular: Çalışmamıza KH tanılı 19 hasta dahil edildi. Ortalama yaş 33±20 aydı. 16 hasta (%84) erkek, 3 hasta (%16)kızdı. Hastalığın en sık görüldüğü mevsim kış (n=6, % 31.5) ve sonbahar (n=6,%31.5)’di. Ateşe eşlik eden en sık şikayet17 (%89) hastada görülen döküntüydü. Hastaların 2’inde pürülan konjunktivit, 2’inde ise süpüratif lenfadenopati gibiatipik bulgular gözlendi. Özellikle inkomplet olgularda tanı için önemli olan destekleyici laboratuvar bulgularından trombositoz hastaların %100’ünde 11.5±2.4. günde tespit edildi. Koroner arter tutulum oranı yüksek olup hastaların %47’indepozitifti. İntravenöz immünglobulin (IVIG) ve asetil salisilik asit (ASA) tedavisi ile koroner tutulumlarda gerileme gözlenirkenbir hastamızda başlangıçta koroner tutulum olmamasına rağmen 2 yıl sonra anevrizma oluşumu tespit edildi.Sonuç: Ülkemizde KH’ında koroner arter tutulumu literatüre göre daha sık görülmektedir. KH pürülan konjunktivit, süpüratif lenfadenit gibi ayırıcı tanıda zorluk oluşturan atipik bulgular görülebilmektedir. Böyle hastalarda da etkin tedavi içineklenecek klinik ve destekleyici laboratuvar bulgularına dikkat edilmelidir. Hastalardaki bu farklılıkların aydınlatılabilmesiiçin genetik ve etiyolojik çalışmalara önem verilmelidir. Hastaların izlemi yeni oluşacak anevrizmaların tespiti açısındanoldukça önemlidir

Kawasaki Disease: Clinical and Epidemiological Characteristics of Our Cases

Objective: Our aim was to determine the typical and atypical clinical findings of our cases with Kawasaki Disease (KD). Material and Methods: Patients who were diagnosed as KD between October 2014 and May 2017 were included in the study. The diagnosis of the patients was made according to the criteria of American Heart Association (AHA). Results: Nineteen patients with KD were included. The mean age was 33±20 months. 16 patients (84%) were male and 3 patients (16%) were female. The most frequent seasons were winter (n=6, 31.5%) and autumn (n=6, 31.5%). The most common complaint accompanying the fever was rash in 17 patients (89%). Atypical findings such as purulent conjunctivitis were seen in 2 patients and suppurative lymphadenopathy in 2 patients. As a supportive laboratory finding that is particularly important for the diagnosis in incomplete cases, thrombocytosis was seen in 100% of the patients on the 11.5±2.4th day of fever. The coronary artery involvement rate was high and 47% of the patients were positive. Intravenous immunoglobulin (IVIG) and acetylsalicylic acid (ASA) treatment decreased the dimensions of coronary artery dilatation. Although there was no initial coronary involvement in one of our patients, an aneurysm formation was detected 2 years later. Conclusion: Coronary artery involvement is more common in our country. Atypical manifestations, such as purulent conjunctivitis and suppurative lymphadenitis, may be encountered and can be difficult to distinguish. One must be careful regarding the clinical and supportive laboratory findings in such patients for effective treatment. Genetic and etiological studies should be emphasized in order to elucidate these differences in patients. The follow-up of the patients is very important for the detection of new aneurysms

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