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急性川崎病:并非仅见于儿童。

Acute Kawasaki disease: not just for kids.

作者信息

Wolff Anne E, Hansen Karen E, Zakowski Laura

机构信息

St. Louis University, St. Louis, Missouri, USA.

出版信息

J Gen Intern Med. 2007 May;22(5):681-4. doi: 10.1007/s11606-006-0100-5.

Abstract

Kawasaki Disease is a small-to-medium-vessel vasculitis that preferentially affects children. Kawasaki Disease can occur in adults, but the presentation may differ from that observed in children. Typical findings in both adults and children include fever, conjunctivitis, pharyngitis, and skin erythema progressing to a desquamating rash on the palms and soles. Adults more frequently present with cervical adenopathy (93% of adults vs. 15% of children), hepatitis (65% vs. 10%), and arthralgia (61% vs. 24-38%). In contrast, adults are less frequently affected by meningitis (10% vs. 34%), thrombocytosis (55% vs. 100%), and coronary artery aneurysms (5% vs. 18-25%). We report a case of acute Kawasaki Disease in a 24-year-old man who presented with rash, fever, and arthritis. He was successfully treated with high-dose aspirin and intravenous immunoglobulin (IVIG). Our case highlights the importance of considering Kawasaki Disease in adults presenting with symptoms commonly encountered in a general medical practice.

摘要

川崎病是一种主要累及儿童的中小血管血管炎。川崎病也可发生于成人,但其临床表现可能与儿童不同。成人和儿童的典型表现均包括发热、结膜炎、咽炎以及进展为手掌和足底脱皮性皮疹的皮肤红斑。成人更常出现颈部淋巴结病(成人中占93%,儿童中占15%)、肝炎(65%对10%)和关节痛(61%对24 - 38%)。相比之下,成人患脑膜炎(10%对34%)、血小板增多症(55%对100%)和冠状动脉瘤(5%对18 - 25%)的情况较少。我们报告一例24岁男性急性川崎病病例,该患者表现为皮疹、发热和关节炎。他通过大剂量阿司匹林和静脉注射免疫球蛋白(IVIG)成功治愈。我们的病例强调了在出现普通医疗实践中常见症状的成人中考虑川崎病的重要性。

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Adult Kawasaki disease: report of two cases and literature review.成人川崎病:两例报告及文献综述
Semin Arthritis Rheum. 2005 Jun;34(6):785-92. doi: 10.1016/j.semarthrit.2005.01.012.
3
Seasonality and temporal clustering of Kawasaki syndrome.川崎病的季节性和时间聚集性。
Epidemiology. 2005 Mar;16(2):220-5. doi: 10.1097/01.ede.0000152901.06689.d4.
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The immunopathogenesis and management of Kawasaki syndrome.川崎病的免疫发病机制与治疗
Arthritis Rheum. 1998 Sep;41(9):1538-47. doi: 10.1002/1529-0131(199809)41:9<1538::AID-ART3>3.0.CO;2-M.

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