Retrospective evaluation of 130 cases with kawasaki disease follow-up in a tertiary care center in Turkey between 1999 and 2019: a 20-year experience


TOPÇU U., ŞAHİN N., Kayabey Ö., Babaoğlu K.

Postgraduate Medicine, cilt.136, sa.2, ss.189-197, 2024 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 136 Sayı: 2
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1080/00325481.2024.2325334
  • Dergi Adı: Postgraduate Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, CINAHL, EBSCO Education Source, Educational research abstracts (ERA), International Pharmaceutical Abstracts, Veterinary Science Database
  • Sayfa Sayıları: ss.189-197
  • Anahtar Kelimeler: Coronary artery disease, developing countries, immunoglobulins, intravenous infant, kawasaki disease
  • Kocaeli Üniversitesi Adresli: Evet

Özet

Objectives: Kawasaki disease (KD), which is a medium vessel vasculitis, is common in Asian countries and is the most common cause of childhood-acquired heart diseases in developed countries. However, disease course and epidemiological data are limited in non-Asian developing countries like ours. We aimed to evaluate the clinical features and prognosis of patients with KD in our country and ethnicity, one of the referee centers of our country. Methods: Patients with KD in our center for the last 20 years in the pre-COVID-19 pandemic era were included in the study. The clinical and laboratory findings, treatments, and follow-up findings were reviewed retrospectively in different age groups. Results: Of the 130 patients, 82 (63%) were male. The median age at diagnosis was 2.97 years (2 months-11.5 years). Thirty-six (27.7%) patients were diagnosed with incomplete KD, and there was no significant laboratory difference between incomplete KD and complete KD patients. Thirty-three (25.3%) patients had coronary artery lesions (CAL), and it persisted in only 3 of 33 patients. One of 15 patients with IVIG resistance had CAL. The independent risk factors were days of illness at initial IVIG administration for CAL (p = 0.013, OR [95%CI] = 1.20 [1.04–1.38]) and low hemoglobin (p = 0.003, OR [95%CI] = 0.51 [0.33–0.79]) and low sodium for IVIG resistance (p = 0.012, OR [95%CI] = 0.81[0.69–0.95]). Conclusions: The rate of CAL is approximately three times higher in our results than in the Japanese data in recent years. We showed that the time of IVIG administration is the most critical factor for preventing CAL. Wide-ranging studies are needed to decently predict the disease process according to the age and region of patients.