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川崎病并发外周动脉血栓形成:病例报告及文献复习。

Kawasaki disease complicated by peripheral artery thrombosis: a case report and literature review.

机构信息

Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.

West China Medical School of Sichuan University, Chengdu, Sichuan, China.

出版信息

Pediatr Rheumatol Online J. 2022 Sep 5;20(1):77. doi: 10.1186/s12969-022-00738-y.

Abstract

BACKGROUND

Peripheral gangrene is rarely documented as a possible complication of Kawasaki disease (KD). There are many causes of peripheral gangrene, and the common cause is in situ thrombosis or embolism. Most cases are reported to have regrettable outcomes (amputation or necrotic shedding). Herein, we report the successful management of KD complicated by peripheral artery thrombosis in an older Chinese boy, and a review of all cases of peripheral gangrene in KD in the literature.

CASE PRESENTATION

We found that most of the children with this complication were under 1 year old, had a heavy inflammatory response combined with the use of cortisol and immunoglobulin, and most children had coronary artery lesions. In addition, Peripheral gangrene mainly occurred in the subacute or chronic stage, and the prognosis is poor.

CONCLUSIONS

In the presence of high risk factors, we consider it is necessary to monitor coagulation function and administer prophylactic anticoagulation therapy. When peripheral artery thrombosis or embolism occur, heparin and prostaglandins can be used for treatment.

摘要

背景

外周坏疽很少被记录为川崎病(KD)的可能并发症。外周坏疽有许多原因,常见的原因是原位血栓形成或栓塞。大多数病例报告的结局令人遗憾(截肢或坏死脱落)。在此,我们报告了一例年长中国男孩 KD 并发外周动脉血栓形成的成功治疗,并对文献中所有 KD 外周坏疽的病例进行了回顾。

病例介绍

我们发现,大多数有这种并发症的患儿年龄在 1 岁以下,炎症反应严重,同时使用皮质醇和免疫球蛋白,大多数患儿有冠状动脉病变。此外,外周坏疽主要发生在亚急性期或慢性期,预后较差。

结论

在存在高危因素的情况下,我们认为有必要监测凝血功能并预防性抗凝治疗。当发生外周动脉血栓形成或栓塞时,可使用肝素和前列腺素进行治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c25f/9446743/4433cd0b51b3/12969_2022_738_Fig1_HTML.jpg

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