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不完全川崎病病例——一名2个月大的婴儿,发热1天,出现多个动脉瘤。

A case of incomplete Kawasaki disease - A 2-month-old infant with 1 day of fever who developed multiple arterial aneurysms.

作者信息

Tsuda Keitaro, Kiyomatsu Kouki, Teramachi Yozo, Suda Kenji

机构信息

Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Kyushu, Japan.

出版信息

Ann Pediatr Cardiol. 2022 Sep-Dec;15(5-6):536-538. doi: 10.4103/apc.apc_39_22. Epub 2023 Mar 1.

Abstract

Kawasaki disease (KD) is a systemic vasculitis and is the most frequent pediatric acquired heart disease in developed countries. The diagnosis of KD is typically made by the: ≧ 5 of 6 principal signs. However, approximately 20% of KD patients present with less than 5 of these diagnostic signs but may be suffering from coronary artery aneurysms and have been diagnosed with incomplete KD. In this case report, we describe a 2-month-old infant who showed just fever without any other signs of KD but was suffered from multiple arterial aneurysms, including coronary, pulmonary, and carotid arteries. Because she did not respond to intravenous immunoglobulin infusion, we placed her on plasma exchange that has successfully brought defervescence without any significant complications. This case may represent the end spectrum of incomplete KD in very young infants.

摘要

川崎病(KD)是一种全身性血管炎,是发达国家最常见的儿童后天性心脏病。KD的诊断通常依据6项主要体征中的≥5项。然而,约20%的KD患者出现的诊断体征少于5项,但可能患有冠状动脉瘤,被诊断为不完全KD。在本病例报告中,我们描述了一名2个月大的婴儿,其仅表现为发热,无KD的任何其他体征,但患有多个动脉瘤,包括冠状动脉、肺动脉和颈动脉。由于她对静脉注射免疫球蛋白无反应,我们对她进行了血浆置换,成功实现了退热,且无任何严重并发症。该病例可能代表了非常小的婴儿中不完全KD的最终表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34b8/10158483/6ba67bde40bd/APC-15-536-g001.jpg

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