D'Auria Enza, Salvini Filippo, Ruscitto Antonia, Neri Ilaria Giulini, Ballista Patrizia, Agostoni Carlo, Riva Enrica
Paediatric Department University of Milan- San Paolo Hospital, Via Di Rudinì 8, Milan, 20142, Italy.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.10.2008.1092. Epub 2009 Sep 7.
We present the case of a child who initially presented with gastrointestinal symptoms suggestive of severe rotavirus gastroenteritis complicated by hyponatraemic dehydration. Appropriate intravenous fluid therapy was administered but the patient, still feverish, developed anasarca probably due to hyperpermeability of microvessels following massive inflammation. Atypical Kawasaki disease was diagnosed on the basis of the clinical findings and laboratory tests. An echocardiogram performed on the 14th day showed a coronary artery aneurysm of the right coronary artery and a generalised dilation of left coronary artery without pericardial effusion. Anasarca in Kawasaki disease has never been reported before in the literature. A rotavirus infection probably triggered the severe and atypical signs in the case reported here.
我们报告一例患儿，其最初表现为提示严重轮状病毒胃肠炎并伴有低钠血症性脱水的胃肠道症状。给予了适当的静脉补液治疗，但该患儿仍发热，可能由于大量炎症后微血管通透性增加而出现全身水肿。根据临床表现和实验室检查诊断为非典型川崎病。在第14天进行的超声心动图显示右冠状动脉有冠状动脉瘤，左冠状动脉普遍扩张，无心包积液。川崎病中的全身水肿在文献中此前从未有过报道。轮状病毒感染可能引发了本文报道病例中的严重且非典型症状。
