Division of Allergy Immunology, Department of Pediatrics, Advanced Pediatrics Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Pediatr. 2012 Jun;79(6):813-4. doi: 10.1007/s12098-011-0552-4. Epub 2011 Aug 24.
Kawasaki disease (KD) is an acute febrile illness of infants and young children that is characterized by a medium vessel vasculitis, most commonly involving the coronary arteries. Though subclinical myocarditis is rather common in KD, symptomatic congestive heart failure is extremely uncommon. The authors report a 9-y-old boy who developed heart failure (ejection fraction 28%) in the acute phase of KD. He was initially treated with intravenous immunoglobulin (2 g/kg) without much clinical improvement. He was then given 5 daily pulses of intravenous methylprednisolone followed by tapering doses of oral prednisolone. The child showed prompt clinical recovery and remains well on follow-up. The present case serves to highlight the fact that methylprednisolone can be considered upfront as rescue therapy in children with KD who have symptomatic congestive cardiac failure during the acute stage of the disease.
川崎病（KD）是一种婴儿和幼儿的急性发热疾病，其特征为中等大小血管炎，最常累及冠状动脉。虽然川崎病中无症状性心肌炎相当常见，但有症状的充血性心力衰竭极为罕见。作者报告了一例 9 岁男孩，在川崎病的急性期发生心力衰竭（射血分数 28%）。他最初接受了静脉注射免疫球蛋白（2 g/kg）治疗，但临床改善不大。随后，他接受了 5 天的静脉甲基强的松龙冲击治疗，随后逐渐减少口服泼尼松龙的剂量。患儿迅速临床恢复，随访情况良好。本病例提示，对于在疾病急性期有症状性充血性心力衰竭的川崎病患儿，可考虑甲基强的松龙作为抢救治疗。
