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

ABSTRACT

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.

KEYWORDS:

• Coronary artery disease
• developing countries
• immunoglobulins
• intravenous infant
• kawasaki disease

Ethical statements

The study was approved by the Ethics Committee of Kocaeli University, Faculty of Medicine, Kocaeli, Turkey (2017/371). Written consent was obtained from the patients and their parents for the use of their medical information in scientific studies.

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. A reviewer in this manuscript has received an honorarium from IPGM for their review work. Peer reviewers in this manuscript have no other relevant financial relationships or otherwise to disclose.

Author contributions

All authors contributed to the study’s conception and design. All authors performed data collection and analysis. The first draft of the manuscript was written by Uğur Topçu and Nihal Şahin, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Additional information

Funding

This paper was not funded.