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[川崎病]

[Kawasaki disease].

作者信息

Gliwińska E

机构信息

Oddział Obserwacyjno-Zakaźny Centralnego Szpitala Klinicznego MSW.

出版信息

Przegl Epidemiol. 1995;49(1-2):9-16.

PMID:7545822
Abstract

Kawasaki disease (KD), first described in Japan in 1967 by Dr. Tomisaku Kawasaki, is an acute multi system vasculitis of infancy and early childhood characterised by high fever, rash, conjunctivitis, inflammation of the mucous membranes, erythematous induration of the hands and feet and cervical lymphadenopathy. Synonyms for Kawasaki disease include "Kawasaki syndrome" and "mucocutaneous lymph node syndrome" (MCLS, MLNS, MCLNS). Kawasaki disease was initially presumed to occur only in Japan; but now this disease is known in the whole world. The first cases in the United States were reported in Hawaii in 1976. In poland 5 cases were recognized, and first time described in 1981. The etiology of Kawasaki disease remains unknown. Toxic, allergic and immunologic causes have been suspected, but most investigators favor an infectious cause or an immune response to an infectious agent. Among classes of microorganism suspected of causing Kawasaki disease were bacteria, leptospires, fungi, rickettsiae and a number of viruses. Recently, there has been considerable interest in the possibility, that Kawasaki disease is caused by RETROVIRUSES. Although the disease is generally benign and self-limited, about 20% of children develop coronary artery aneurysms. In 5% of cases, giant aneurysm/more then 8 mm/develop, predisposing the patient to acute coronary artery thrombosis, myocardial infarction and sudden death. This is the most serious complication of KD. Other manifestations of hearth involvement, include pericarditis, myocarditis, myocardial failure and mitral regurgitation. Besides this many other clinical findings are commonly noted in KD; such as: pneumonia, diarrhea, arthritis, aseptic meningitis, otitis media, obstructive jaundice, hydrops of gallbladder and others.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

川崎病(KD)于1967年由日本的川崎富作医生首次描述,是一种婴幼儿期的急性多系统血管炎,其特征为高热、皮疹、结膜炎、黏膜炎症、手足红斑硬结和颈部淋巴结病。川崎病的同义词包括“川崎综合征”和“黏膜皮肤淋巴结综合征”(MCLS、MLNS、MCLNS)。川崎病最初被认为仅在日本发生;但现在全世界都知晓这种疾病。1976年美国夏威夷报道了首例病例。在波兰,1981年首次识别并描述了5例病例。川崎病的病因仍然不明。曾怀疑有毒性、过敏和免疫方面的原因,但大多数研究者倾向于感染性病因或对感染因子的免疫反应。怀疑导致川崎病的微生物类别包括细菌、钩端螺旋体、真菌、立克次体和多种病毒。最近,人们对川崎病由逆转录病毒引起的可能性产生了浓厚兴趣。尽管该疾病通常为良性且具有自限性,但约20%的儿童会发展为冠状动脉瘤。在5%的病例中,会出现巨大动脉瘤(直径超过8毫米),使患者易发生急性冠状动脉血栓形成、心肌梗死和猝死。这是川崎病最严重的并发症。心脏受累的其他表现包括心包炎、心肌炎、心力衰竭和二尖瓣反流。除此之外,川崎病还常出现许多其他临床症状;如:肺炎、腹泻、关节炎、无菌性脑膜炎、中耳炎、梗阻性黄疸、胆囊积液等。(摘要截选至250词)

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