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[大龄儿童及青年成人中的川崎病:法国马赛十年经验]

[Kawasaki disease in older children and young adults: 10 years of experience in Marseille, France].

作者信息

Bresson V, Bonello B, Rousset-Rouvière C, Serratrice J, Chabrol B, Dubus J-C, Bosdure E

机构信息

Unité de médecine infantile, CHU la Timone-Enfants, 13385 Marseille cedex 5, France.

出版信息

Arch Pediatr. 2011 Jul;18(7):731-6. doi: 10.1016/j.arcped.2011.04.014. Epub 2011 May 19.

Abstract

Kawasaki disease is a well-known disease in young children. However, it can also affect older children. The aim of this study was to determine the different characteristics of Kawasaki disease in older children and young adults. This is a descriptive, retrospective, and multicenter study including all cases of Kawasaki disease occurring in children over 8 years and adults hospitalized at children's or adult Hospitals, in Marseille, France, between 1999 and 2009. The clinical, biological, prognostic, and therapeutic data were reviewed for each case. Over a 10-year period, 98 patients were hospitalized for Kawasaki disease. Six cases were aged between 8 years and 1 month and 21 years and 7 months. All patients showed a classic form of the disease with associated organ damage in 5 patients. A cardiac problem was present in 5 cases with 2 patients needing intensive care. The median time to diagnosis and treatment was 11.2 days, with all patients initially diagnosed erroneously. Current treatment guidelines were applied in 2 patients. Kawasaki disease in children over 8 years and adults under 30 years has a worse prognosis than in young children even though clinical features are atypical. It is rarely seen by clinicians in this age group, causing a delay in diagnosis, the main factor of the poor prognosis. The diagnosis of Kawasaki disease must be raised when predisposing factors are present in this group.

摘要

川崎病在幼儿中是一种广为人知的疾病。然而,它也会影响大龄儿童。本研究的目的是确定大龄儿童和青年成人川崎病的不同特征。这是一项描述性、回顾性的多中心研究,纳入了1999年至2009年期间在法国马赛的儿童医院或成人医院住院的所有8岁以上儿童及成人的川崎病病例。对每个病例的临床、生物学、预后和治疗数据进行了回顾。在10年期间,98例患者因川崎病住院。其中6例年龄在8岁1个月至21岁7个月之间。所有患者均表现为典型的疾病形式,5例伴有相关器官损害。5例存在心脏问题,2例需要重症监护。诊断和治疗的中位时间为11.2天,所有患者最初均被误诊。2例患者应用了当前的治疗指南。8岁以上儿童及30岁以下成人的川崎病预后比幼儿更差,尽管临床特征不典型。该年龄组的临床医生很少见到这种病,导致诊断延迟,这是预后不良的主要因素。当该组存在易感因素时,必须考虑川崎病的诊断。

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