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以巨大冠状动脉扩张为表现的川崎病休克综合征——两例病例报告及文献复习

Kawasaki Disease Shock Syndrome Presented with Giant Coronary Artery Dilatation - Presentation of Two Cases and a Literature Review.

作者信息

Bejiqi Ramush, Pajaziti Nafije, Agushi Shqipe

机构信息

Faculty of Medicine, University of Pristina, Pristina, Kosovo.

出版信息

Acta Inform Med. 2022 Sep;30(3):253-256. doi: 10.5455/aim.2022.30.253-256.

Abstract

BACKGROUND

Kawasaki disease is an acute, self-limited vasculitis of childhood characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in approximately 15 to 25% of untreated children with the disease and may lead to myocardial infarction, sudden death, or ischemic heart disease. Despite an overlap of clinical features with toxic shock syndrome, children with Kawasaki disease generally do not develop shock.

OBJECTIVE

Here we present two adolescent boys who had KDSS and discuss their differentiating features from MIS-C.

CASE REPORTS

Two adolescent children presented with a toxic shock-like illness, and were subsequently diagnosed with Kawasaki disease shock syndrome when coronary artery abnormalities were found on transthoracic echocardiography.

CONCLUSION

Pediatricians and paediatric cardiologists alike should be aware of this potentially severe form of manifestation of the Kawasaki disease which needs to be differentiated from the multisystem inflammatory syndrome in children.

摘要

背景

川崎病是一种儿童期急性自限性血管炎,其特征为发热、双侧非渗出性结膜炎、唇及口腔黏膜红斑、四肢变化、皮疹和颈部淋巴结病。在未经治疗的患儿中,约15%至25%会发生冠状动脉瘤或扩张,这可能导致心肌梗死、猝死或缺血性心脏病。尽管川崎病的临床特征与中毒性休克综合征有重叠,但川崎病患儿一般不会发生休克。

目的

本文介绍两名患有川崎病休克综合征(KDSS)的青少年男性,并讨论其与儿童多系统炎症综合征(MIS-C)的鉴别特征。

病例报告

两名青少年儿童出现中毒性休克样疾病,经胸超声心动图发现冠状动脉异常后,随后被诊断为川崎病休克综合征。

结论

儿科医生和儿科心脏病专家均应意识到川崎病这种潜在的严重表现形式,它需要与儿童多系统炎症综合征相鉴别。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75c3/9559664/8e856e913dd6/AIM-30-253-g001.jpg

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