Clinical and Epidemiological Characteristics of Cases Monitored by the Diagnosis of Kawasaki Disease

Objective: Kawasaki disease (KD) is an acute systemic vasculitis which is more common in children between 6 months and 5 years of age. The aim of this study was to evaluate the epidemiological and clinical features of patients diagnosed with KD and treated in our Pediatric Infection Disease Clinic for the past decade. Material and Methods: Forty-one cases with the diagnosis of KD from the retrospective file records were evaluated in terms of epidemiological, clinical, laboratory, treatment and complications at Sisli Hamidiye Etfal Pediatric Infection Clinic between 1st January 2008 and 31st December 2017. Four out of five semptoms resulting from at least five days of fever with rash, extremity changes, intra-oral mucosa and lip involvement, non-purulent conjunctivitis and cervical lymphadenopathy were diagnosed as classic Kawasaki. Intravenous immunoglobulin (IVIG) and acetylsalicylic acid treatment were administered to all patients upon diagnosis. Results: 41 patients were included in the study, the mean age was 29.2 +/- 20.7 months (2-76 months), 24 (58.5%) were male and 17 (41.5%) were female. 87.8% of the patients were under the age of five and 43.9% were under two years of age. Diagnosis acquisition time was 8.2 +/- 2.8 (5-16 days) days. Most patients were diagnosed in spring and winter. The most common findings were nonpurified conjunctivitis (97.6%) and oral mucosa and lip change (92.7%). 24 (58.5%) patients were diagnosed as complete KD. 17 (41.5%) patients were evaluated as incomplete KD. Coronary artery involvement was detected in 25 (60.9%) patients, three patients had mitral regurgitation (MR) accompanied by coronary involvement, while MR and pericardial effusion were detected in two patients. A second dose of IVIG treatment was administered to 4 (9.8%) patients who did not respond to a first dose of IVIG treatment. Conclusion: Kawasaki disease is a clinically defined systemic vasculitis of mainly medium-sized arteries. Due to incomplete cases that do not fully meet the diagnostic criteria, all criteria should not be expected to be met in the diagnosis of KD for a case of fever lasting more than 5 days. While there may be serious complications in cases of delay in diagnosis and in cases of non-responsiveness to treatment, a good prognosis is usually obtained with early diagnosis and correct treatment.