Gedalia Abraham
Departments of Pediatrics, LSU Health Sciences Center and Children's Hospital, 1542 Tulane Avenue, T8-1, New Orleans, LA 70112, USA.
Curr Rheumatol Rep. 2002 Feb;4(1):25-9. doi: 10.1007/s11926-002-0020-2.
Kawasaki disease (KD) was first reported in Japan more than 30 years ago, but the original diagnostic clinical criteria defined by Dr. Kawasaki are still authentic. The cause of KD remains unknown. Several epidemiologic and clinical observations suggest that it is caused by one or multiple infectious agents, each of which can result in the clinical manifestation of the disease. Advances have been made in the management of the disease with the introduction of aspirin and intravenous immunoglobulin (IVIG) that have had a significant impact on lowering the rate of coronary artery aneurysms and death from the disease. Questions remain regarding the management of those patients whose disease does not respond to IVIG. Some patients with severe KD who are resistant to IVIG may benefit from IV pulse steroids therapy. It remains to be seen whether steroid or other anti-inflammatory agents play a role in the management of patients with KD. Further research studies are needed to identify the possible cause, define the treatment, and predict the long-term outcome of this enigmatic disease.
川崎病（KD）于30多年前首次在日本被报道，但是川崎医生最初定义的诊断临床标准仍然适用。KD的病因尚不清楚。多项流行病学和临床观察表明，它是由一种或多种感染因子引起的，每种感染因子都可导致该疾病的临床表现。随着阿司匹林和静脉注射免疫球蛋白（IVIG）的引入，该疾病的治疗取得了进展，这对降低冠状动脉瘤的发生率和该病的死亡率产生了重大影响。对于那些对IVIG无反应的患者的治疗，仍存在问题。一些对IVIG耐药的重症KD患者可能从静脉注射脉冲类固醇治疗中获益。类固醇或其他抗炎药在KD患者的治疗中是否起作用还有待观察。需要进一步的研究来确定可能的病因、明确治疗方法并预测这种神秘疾病的长期预后。
