title: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, American Hospital, Istanbul, Turkey. sinanmahir@gmail.com
authors.forename: Sinan Mahir
authors.initials: SM
authors.lastname: Kayiran
authors.forename: Aygün
authors.initials: A
authors.lastname: Dindar
authors.forename: Berkan
authors.initials: B
authors.lastname: Gurakan
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D012016:Reference Values; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors