González Pascual E, Villanueva Lamas J, Ros Viladoms J, Pons Odena M, Ruiz García-Diego S
Unidad Integrada Hospital Clínico-Hospital, Sant Joan de Dèu, Servicio de Pediatría, Barcelona.
An Esp Pediatr. 1999 Jan;50(1):39-43.
We present 50 cases of Kawasaki's disease (KD), diagnosed and controlled in our hospital between January 1984 and December 1997.
Fifty patients were reviewed. In forty-six of these cases the onset was complete, according to the Research Committee of MLNS diagnosis criteria and four cases had incomplete onset.
The ration male/female was 1.9/1. Both fever and oral cavity lesions were present in all cases. In 93.4% desquamation of fingers was observed. The most frequent skin lesion was maculopapular rash. Fourteen patients had atypical onset: adenophlegmon, aseptic meningitis, symptomatic hepatitis, parotiditis, queratopathia punctata and arthritis. Blood analysis showed alterations of high ESR (88% of cases), C-reactive protein (62%), leukocytosis (82%) and thrombocytosis (96%). Fifteen patients were treated with gamma globulin (IGIV), five received a single 2 g/Kg dose and ten received 400 mg/Kg per day during four days. Eight percent of our cases produced cardiovascular complications, none that included coronary aneurysms.
After IGIV treatment we observed a shortening of the febrile period and amelioration of clinical symptoms. No deaths were reported.
我们呈现1984年1月至1997年12月期间在我院诊断并得到控制的50例川崎病(KD)病例。
对50例患者进行了回顾性研究。根据MLNS诊断标准,其中46例起病完整,4例起病不完整。
男女比例为1.9/1。所有病例均有发热和口腔损害。93.4%的患者出现手指脱皮。最常见的皮肤损害是斑丘疹。14例患者有非典型起病:腺性蜂窝织炎、无菌性脑膜炎、症状性肝炎、腮腺炎、点状角膜病变和关节炎。血液分析显示血沉升高(88%的病例)、C反应蛋白升高(62%)、白细胞增多(82%)和血小板增多(96%)。15例患者接受了静脉注射丙种球蛋白(IGIV)治疗,5例接受单次2g/kg剂量,10例在4天内每天接受400mg/kg剂量。我们的病例中有8%出现心血管并发症,无一例包括冠状动脉瘤。
静脉注射丙种球蛋白治疗后,我们观察到发热期缩短,临床症状改善。无死亡病例报告。