Dermatology Department, Instituto Nacional de Pediatría, Mexico City, Mexico.
Allergy and Clinical Immunology, Hospital Infantil de Especialidades de Chihuahua, Chihuahua, Mexico.
Pediatr Int. 2021 Aug;63(8):880-888. doi: 10.1111/ped.14561. Epub 2021 Jul 16.
Kawasaki disease (KD) is an acute systemic vasculitis that predominantly affects patients younger than 5 years. In the absence of an available, affordable diagnostic test, detailed clinical history and physical examination are still fundamental to make a diagnosis.
We present five representative cases with KD-like presentations: systemic onset juvenile idiopathic arthritis, mycoplasma-induced rash and mucositis, staphylococcal scalded skin syndrome, BCGosis, and the recently described multisystemic inflammatory syndrome in children (MIS-C) associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) virus.
Rash, fever, and laboratory markers of inflammation can be present in several childhood diseases that may mimic KD.
The term 'Kawasaki syndrome' instead of 'Kawasaki disease' may be more appropriate. Physicians should consider an alternative diagnosis that may mimic KD, particularly considering MIS-C during the present pandemic, as an aggressive diagnostic and therapeutic approach is needed.
川崎病(KD)是一种主要影响 5 岁以下患者的急性全身性血管炎。在没有可用且负担得起的诊断测试的情况下,详细的临床病史和体格检查仍然是做出诊断的基础。
我们呈现了五个具有 KD 样表现的代表性病例:全身型幼年特发性关节炎、支原体引起的皮疹和黏膜炎、葡萄球菌烫伤样皮肤综合征、卡介苗病,以及最近描述的与严重急性呼吸综合征冠状病毒 2(SARS-CoV2)病毒相关的儿童多系统炎症综合征(MIS-C)。
皮疹、发热和炎症的实验室标志物可存在于几种可能模仿 KD 的儿童疾病中。
使用“川崎综合征”而非“川崎病”这个术语可能更为恰当。医生应考虑可能模仿 KD 的其他诊断,特别是在当前大流行期间要考虑 MIS-C,因为需要采取积极的诊断和治疗方法。