Silva Carlos H M da, Roscoe Isabel C R G, Fernandes Karla P, Novaes Ricardo M, Lázari Carolina S
Universidade Federal de Uberlândia, MG, Brazil.
J Pediatr (Rio J). 2002 Jan-Feb;78(1):71-4.
Kawasaki disease is a systemic idiopathic self-limited vasculitis of small and medium-sized vessels. Thirteen cases of sensorineural hearing loss during the evolution of this disease have been described in the literature. We describe a case of an infant with Kawasaki disease who developed sensorineural hearing loss during the acute phase. This case report shows a complication of Kawasaki disease, with few citations in literature, enhancing the importance of careful evaluation of these patients. DESCRIPTION: Nineteen-month-old-boy, formerly healthy, with persistent daily fever seven days before admission, associated with irritability, bilateral nonexudative conjunctivitis and maculopapular erythema on his trunk. There was later development of arthritis on wrists, elbows, knees, and ankles, and swelling associated with desquamation of hands and feet, which prevented him from walking. The diagnosis of Kawasaki disease was established according to the American Heart Associatiońs criteria, and the child was conventionally treated. There was regression of clinical manifestations three days after the beginning of treatment. However, one month after the onset of symptoms, the family noticed an unsatisfactory response to sound stimuli. The evaluation of auditory acuity through BERA (Brainstem Evoked Responses Audiometry) revealed severe bilateral sensorineural hearing loss. COMMENTS: Routine examination of auditory acuity in children with Kawasaki disease may help identify sensorineural hearing loss at an early stage.
川崎病是一种累及中小血管的全身性特发性自限性血管炎。文献中已报道了13例该病病程中出现感音神经性听力损失的病例。我们描述了1例川崎病婴儿在急性期出现感音神经性听力损失的情况。本病例报告展示了川崎病的一种并发症，文献中相关引用较少，凸显了对这些患者进行仔细评估的重要性。
一名19个月大的男童，既往健康，入院前持续每日发热7天，伴有烦躁、双侧非渗出性结膜炎以及躯干出现斑丘疹性红斑。随后出现手腕、肘部、膝盖和脚踝的关节炎，以及手足肿胀伴脱皮，导致他无法行走。根据美国心脏协会的标准确诊为川崎病，该患儿接受了常规治疗。治疗开始3天后临床表现消退。然而，症状出现1个月后，家人注意到患儿对声音刺激反应不佳。通过脑干听觉诱发电位（BERA）进行的听力评估显示双侧严重感音神经性听力损失。
对川崎病患儿进行常规听力检查可能有助于早期发现感音神经性听力损失。
