An evaluation of children with Kawasaki disease in Istanbul: a retrospective follow-up study

Abstract

BACKGROUND:Kawasaki disease (KD) is an acute, self‐limiting vasculitis of unknown etiology. The incidence of KD is increasing world wide. However, the epidemiological data for KD in Turkey has not been well described.OBJECTIVE:To describe the demographic, clinical, and laboratory features of children with KD who were diagnosed and managed in the American Hospital, Istanbul, Turkey.METHOD:Patients with KD were retrospectively identified from the hospital discharge records between 2002 and 2010. Atypical cases of KD were excluded. A standardized form was used to collect demographic data, clinical information, echocardiography and laboratory results.RESULTS:Thirty‐five patients with KD, with a mean age of 2.5±1.9 years, were identified. Eighty‐five point seven per cent of patients were under 5 years of age. A seasonal pattern favouring the winter months was noticed. In addition to fever and bilateral conjunctival injection, changes in the oral cavity and lips were the most commonly detected clinical signs in our cases. Coronary artery abnormalities were detected in nine patients. The majority of our patients had started treatment with intravenous immunoglobulin in the first 10 days of the onset of fever, and only one patient required systemic steroids for intravenous immunoglobulin‐resistant KD. The coronary artery abnormalities resolved in all nine patients within 8 months.CONCLUSION:This study is the most comprehensive series of children from Turkey with KD included in Medline. As adult‐onset ischemic heart disease may be due to KD in childhood, further prospective clinical investigations are needed to understand the epidemiology, management and long‐term follow‐up of the disease.

Is there any difference in clinical features of Turkish children with Kawasaki disease?

“…Like our study, Gülhan et al (2) were noticed that there was no gender predominance in Turkish children with KD, and they also mentioned that the earlier occurrence of desquamation and cardiovascular disease than expected by conventional teaching. Likewise previous Turkish patient series (1)(2)(3)(4), the most common clinical finding was changes in the lips and oral cavity in our study. We also observed that most of our patients were irritable at the time of the diagnosis.…”

“…There are few studies concerning the characteristic features of Turkish children diagnosed with KD (1)(2)(3)(4). We aimed to identify the clinical characteristics and potential risk factors for coronary artery abnormalities (CAAs) in Turkish children diagnosed with KD.…”

“…The other important feature of the Turkish children with KD was a relatively high rate of coronary artery abnormalities which occurs in up to 44.2% of patient series (1)(2)(3)(4)(5). Approximately, 10-33% of cases with KD have incomplete presentation and they have also had an increasing risk for development of CAA (1-5).…”

Clinical Evaluation of Children with Kawasaki Disease Hospitalized in Our Clinic: A Retrospective Study

“…[15,16] In other studies performed both in our country and abroad, lymphadenopathy was the least frequently reported diagnostic criterion. [17,18] In the present study, while cervical lymphadenopathy was detected in 61.5% of the patients, it was the least frequently seen symptom. Perrin et al [19] reported a lower incidence rate for peripheral extremity lesions, conjunctivitis, and skin rashes in incomplete Kawasaki disease compared with the complete form of the disease.…”

“…In other studies performed in our country too, leukocytosis, anemia, and thrombocytosis were observed in patients diagnosed with Kawasaki disease. [11,16,17] In cases of Kawasaki disease, the ESR and CRP values are almost always increased. In our study, the mean ESR value was 60 mm/hour, and the mean CRP was 108 mg/dL.…”