川崎病：来自坦桑尼亚达累斯萨拉姆 Aga Khan 医院的两例病例报告。
Kawasaki disease: two case reports from the Aga Khan Hospital, Dar es Salaam-Tanzania.
机构信息
Aga Khan Hospital, Dar es Salaam, Tanzania.
出版信息
BMC Pediatr. 2018 Oct 23;18(1):334. doi: 10.1186/s12887-018-1306-5.
BACKGROUND
Kawasaki disease is a common childhood vasculitis which may result in cardiovascular morbidity if not adequately treated. Its epidemiology in the African region is not well described. Its features may mimic other childhood infections and hemoglobinopathies and it is rarely diagnosed in the East African region. These are the first reports of this disease from Tanzania.
CASE PRESENTATION
We present two cases of complete Kawasaki disease seen over a 2 year period and diagnosed as per the criteria defined by the American Heart Association. One child was and infant and the other a 3 year old. Both of them presented with a prolonged fever and mucocutaneous findings. None of the children developed coronary artery aneurysms. One was treated with aspirin alone and the other with both aspirin and intravenous immunoglobulin. Both children had complete recovery and did not have any cardiovascular sequelae.
CONCLUSION
Kawasaki disease may be more common in the East African region than previously thought. It should be considered as a differential diagnosis in children who present with a prolonged fever of greater than 5 days and mucocutaneous findings. More awareness about this condition, its epidemiology, diagnosis and management are required in order to prevent the cardiovascular morbidity associated with it.
背景
川崎病是一种常见的儿童血管炎，如果治疗不充分，可能导致心血管并发症。其在非洲地区的流行病学情况尚未得到充分描述。川崎病的特征可能与其他儿童感染和血红蛋白病相似，在东非地区很少被诊断。这是坦桑尼亚首例报告的川崎病病例。
病例介绍
我们报告了两例在 2 年内观察到的完全川崎病病例，并根据美国心脏协会定义的标准进行了诊断。其中一个患儿是婴儿，另一个是 3 岁儿童。他们都表现出持续发热和黏膜皮肤表现。没有患儿发生冠状动脉瘤。一个患儿仅接受阿司匹林治疗，另一个患儿同时接受阿司匹林和静脉注射免疫球蛋白治疗。两个患儿均完全康复，没有任何心血管后遗症。
结论
川崎病在东非地区可能比以前认为的更为常见。对于发热持续超过 5 天且有黏膜皮肤表现的儿童，应将其作为鉴别诊断。为了预防与川崎病相关的心血管并发症，需要提高对该病的认识，包括其流行病学、诊断和管理。
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