Kawasaki Hastalığında Kobayashi Skorunun İncelenmesi

Abstract

Kawasaki disease (KD) is one of the most common vasculitis of childhood. Coronary artery involvement is the most important complication of the disease and the major cause of the mortality. IVIG resistance is defined as persisting or recurring fever at least 36 hours after the end of intravenous infusion of immunoglobulin (IVIG). The aim of this study is to assess the success of the Kobayashi scores and other parameters in predicting IVIG resistance and coronary artery involvement in Turkish population. Patients who were diagnosed in the acute phase of Kawasaki disease at Hacettepe University Faculty of Medicine (Ankara,Turkey) between June 2007- February 2018 were retrospectively reviewed and included in this study. Of the 100 patients who were administered IVIG, 85 (85%) responded to IVIG treatment, whereas 15 (15%) were IVIG resistant. Coronary aneurysm was detected in echocardiography at diagnosis in 31 patients. As a consequence in univariate analyses, patients younger than 1 year, high erythrocyte sedimentation rate, high white blood cell count, low hematocrit were found to be the risk factors for coronary aneurysms but in multivariate analyses high white blood cell count, low hematocrit were statistically significant risk factors for coronary involvement. Compared with the IVIG-responsive group, the IVIG-resistant group had higher C-reactive protein(CRP) and gamma glutamyl transpeptidase (GGT) levels. In multivariate analyses high GGT levels was statistically significant risk factors for IVIG-resistance. No significant differences were found between the IVIG-resistant and IVIG-responsive groups in terms of age. Twenty patients had Kobayashi high-risk scores, 9 patients had Egami high risk scores. The Formosa score assigned 45 patients as high-risk. The Harada score assigned 54 patients as high-risk. None of these scores predicted coronary involvement and IVIG resistance in the Turkish population.