Chen Wan-Teh, Huang Shouh-Ren, Wang Jou-Kou
Department of Pediatrics, Taiwan Adventist Hospital, No. 424 Pa Te Road, Section 2, Taipei 105, Taiwan.
Acta Paediatr Taiwan. 2003 May-Jun;44(3):174-6.
Kawasaki disease predominantly affects children younger than 5 years. Coronary artery aneurysms were found in around 20% of untreated patients. We report on a case of a 10-year-old boy who had atypical presentation of Kawasaki disease with significant hepatobiliary dysfunction, including hepatomegaly and jaundice, and persistent fever. He did not have conjunctivitis until the 8th day of fever, and periungual desquamation and strawberry tongue until the 13th day of fever when Kawasaki disease was diagnosed. Echocardiography revealed multiple coronary artery aneurysms. Such atypical clinical pictures of Kawasaki disease may cause delay in the treatment, and the fatality rate can be increased. So, a persistent fever with jaundice should evoke the differential diagnosis of Kawasaki disease.
川崎病主要影响5岁以下儿童。在约20%未经治疗的患者中发现冠状动脉瘤。我们报告一例10岁男孩,他表现为非典型川崎病,伴有明显的肝胆功能障碍,包括肝肿大和黄疸,且持续发热。他在发热第8天才出现结膜炎,在发热第13天诊断为川崎病时才出现指(趾)端脱皮和草莓舌。超声心动图显示多发冠状动脉瘤。川崎病这种非典型临床表现可能导致治疗延误,并可能增加死亡率。因此,持续发热伴黄疸应引发对川崎病的鉴别诊断。