AI Summary & Key Takeaways
AI InsightHe has been followed up since one year, with 3 months intervals and his systemic examination is found normal.The case was presented because of the associated hypertension which is an unusual manifestation in the early stage of thet disease.
📌 3 Key Takeaways
Abstract
Kawasaki syndrome is a multisystemic vasculitis predominantly affecting medium sized arteries. It causes aneurysm formation in coronary arteries and other middle-sized arteries of the body in 15-25% of the patients. Hypertension due to affected renal arteries is reported as a late stage complication. Five years old boy, admitted to hospital with elevated prolonged temperature, swelling on the neck, and erythematous rashes on the trunk was diagnosed as a Kawasaki syndrome with prolonged high fever, left cervical nonpurulent lymphadenomegaly sized 1.5x2x2 cm, maculopapular rash and bilateral nonexudative conjunctivitis. His blood pressure was measured 170/110 mm Hg during his first physical examination. Echocardiography, p-ANCA, c-ANCA, VMA, ANA, direct coombs, renal scintigraphy, renal magnetic resonans angiography, had done to make differential diagnosis with the other vasculitic syndromes, were found in normal ranges, but plasma renin level was found high. Intravenous immunglobulin, acetylsalicylic acid and three antihypertensive drugs were used in the treatment and antihypertensive theraphy was discontinued at the 19th day of the therapy. He has been followed up since one year, with 3 months intervals and his systemic examination is found normal.The case was presented because of the associated hypertension which is an unusual manifestation in the early stage of thet disease.
Özet
Kawasaki sendromu, orta çaplı damarları tutan multisistemik bir vaskülittir. Koroner arterler ve vücudun diğer orta-büyük çaplı arterlerinde %15-25 oranında anevrizmatik değişikliklere neden olmaktadır. Renal arter tutulumuna bağlı gelişen hipertansiyon, geç dönem komplikasyonu olarak bildirilmektedir. Hastanemize ısrarlı yüksek ateş, boyunda şişlik, vücudda döküntü yakınmaları ile başvuran 5 yaşındaki erkek olgu yüksek ateş, sol servikal 1.5x2x2 cm nonsüpüratif lenfadenomegali, makülopapüler döküntü, bilateral nonpürülan konjoktiviti ile Kawasaki sendromu tanısı almıştır. Kabulünde ölçülen arteriyal kan basıncı (KB) 170/110 mm Hg bulunmuş, diğer vaskülit sendromlarmdan ayırım için yapılan ekokardiografi, P-ANCA, C-ANCA, VMA, ANA, D. Coombs, renal sintigrafi, renal manyetik rezonans anjiografi normal, kan renin düzeyi yüksek saptanmıştır. Tedavide intravenöz immunglobulin, asetil şahsilik asit ve üçlü anti-hipertansif kullanılan olguda 19. günde antihipertansif tedavi kesilmiştir. Üç ay ara ile yapılan bir yıllık kontrollerinde sistem bulguları normal olup izlemdedir. Olgu Kawasaki sendromunun erken evresinde eşlik eden hipertansiyon nedeniyle dikkat çekmek için sunulmuştur.