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[墨西哥一家儿科医院的川崎病]

[Kawasaki disease at a pediatric hospital in Mexico].

作者信息

García Rodríguez Fernando, Flores Pineda Ángel de Jesús, Villarreal Treviño Ana Victoria, Salinas Encinas Diego Rubén, Lara Herrera Paola Bernardett, Maldonado Velázquez María Del Rocío, Moreno Espinosa Sarbelio, Faugier Fuentes Enrique

机构信息

Servico de Reumatología, Hospital Infantil de México Federico Gómez, Ciudad de México, México.

Departamento de Infectología, Hospital Infantil de México Federico Gómez, Ciudad de México, México.

出版信息

Bol Med Hosp Infant Mex. 2016 May-Jun;73(3):166-173. doi: 10.1016/j.bmhimx.2016.01.002. Epub 2016 May 31.

Abstract

BACKGROUND

Kawasaki disease (KD) is one of the most common systemic vasculitis in children under 5 years of age. The epidemiology of the disease is not well established in Mexico. The objective of this study was to describe the epidemiology, clinical features and treatment of patients with KD at the Hospital Infantil de Mexico Federico Gomez (HIMFG).

METHODS

We conducted a retrospective, descriptive and analytical study of patients diagnosed from January 2004 to December 2014 with KD in the HIMFG.

RESULTS

We analyzed 204 cases from which 55% were male, with a median age of 32.5 months (6-120) and a rate of hospitalization of 96%. Twenty percent of patients presented incomplete KD. No differences in the somatometric measurements or vitals were reported. The most frequent symptoms were fever, conjunctivitis (89%), oral changes (84%), pharyngitis (88%) and strawberry tongue (83%). We found higher acute phase reactants in the classic presentation. Echocardiographic alterations in 60 patients (29%), of which 12% were ectasia and 11% reported coronary aneurysms. On the other hand, 169 (83%) patients received intravenous immunoglobulin (IVIG), 18 (9%) presented resistance to IVIG, 6 (3%) required corticosteroids, and 2 (1%) infliximab; all received acetylsalicylic acid.

CONCLUSIONS

There were no important differences between classic and incomplete presentations. The incidence of cardiac alterations is less than previously reported in Mexico, but similar to that of other countries.

摘要

背景

川崎病(KD)是5岁以下儿童中最常见的全身性血管炎之一。该疾病在墨西哥的流行病学情况尚未完全明确。本研究的目的是描述墨西哥联邦区费德里科·戈麦斯儿童医院(HIMFG)中川崎病患者的流行病学、临床特征及治疗情况。

方法

我们对2004年1月至2014年12月在HIMFG诊断为川崎病的患者进行了一项回顾性、描述性和分析性研究。

结果

我们分析了204例病例,其中55%为男性,中位年龄为32.5个月(6 - 120个月),住院率为96%。20%的患者表现为不完全川崎病。在体格测量或生命体征方面未报告有差异。最常见的症状是发热、结膜炎(89%)、口腔改变(84%)、咽炎(88%)和草莓舌(83%)。我们发现典型表现的患者急性期反应物水平更高。60例患者(29%)有超声心动图改变,其中12%为血管扩张,11%报告有冠状动脉瘤。另一方面,169例(83%)患者接受了静脉注射免疫球蛋白(IVIG),18例(9%)对IVIG耐药,6例(3%)需要使用皮质类固醇,2例(1%)使用英夫利昔单抗;所有患者均接受了乙酰水杨酸治疗。

结论

典型和不完全表现之间没有重要差异。心脏改变的发生率低于墨西哥此前报告的水平,但与其他国家相似。

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