Nishigaki Koji, Takahashi Kunihiko, Hamano Shota, Ota Masaki, Kato Ayuka, Noguchi Kyoko, Onoe Taisuke, Nishimoto Shizuka, Kikkawa Makiko, Tokunaga Yasuyuki, Chayama Kosuke
Department of Pediatrics, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka, Osaka, 560-8565, Japan.
Pediatr Cardiol. 2025 Mar 27. doi: 10.1007/s00246-025-03836-2.
Kawasaki Disease (KD) is an acute vasculitis primarily affecting children and can lead to coronary artery lesions (CALs) if not promptly diagnosed and treated. Indolent KD, characterized by spontaneous fever resolution without early intervention, poses diagnostic challenges as patients may not initially meet the complete diagnostic criteria, delaying treatment and increasing the risk of CAL development. We report a case of a 17-month-old boy with indolent KD who developed CAL on the 18th day of illness, necessitating IVIG therapy. Despite initial symptom resolution, echocardiographic monitoring revealed delayed coronary artery involvement, underscoring the importance of proactive imaging. This case highlights the need for frequent echocardiographic evaluation in indolent KD, particularly when clinical and laboratory findings are inconclusive. Serial imaging facilitates early detection of CALs, enabling timely IVIG therapy and potentially preventing disease progression. A structured follow-up strategy is crucial in managing indolent KD to reduce the risk of long-term cardiovascular complications.
川崎病（KD）是一种主要影响儿童的急性血管炎，如果不及时诊断和治疗，可导致冠状动脉病变（CALs）。惰性KD的特点是未经早期干预发热自行消退，由于患者最初可能不符合完整的诊断标准，这给诊断带来了挑战，导致治疗延迟并增加了CAL发生的风险。我们报告一例17个月大患惰性KD的男孩，在患病第18天出现CAL，需要静脉注射免疫球蛋白（IVIG）治疗。尽管最初症状有所缓解，但超声心动图监测显示冠状动脉受累延迟，突出了主动成像的重要性。该病例强调了对惰性KD进行频繁超声心动图评估的必要性，特别是当临床和实验室检查结果不明确时。系列成像有助于早期发现CALs，从而能够及时进行IVIG治疗并可能预防疾病进展。在管理惰性KD时，结构化的随访策略对于降低长期心血管并发症的风险至关重要。
