Bolz D, Arbenz U, Fanconi S, Bauersfeld U
Division of Cardiology, Children's University Hospital, Zürich, Switzerland.
Eur J Pediatr. 1998 Jul;157(7):589-91. doi: 10.1007/s004310050885.
Acute heart failure in the early neonatal period is rare. Normally it is due to asphyxia, severe septicaemia, a congenital heart malformation or a viral myocarditis. Kawasaki disease (KD) as a cause of an neonatal myocarditis is not an established diagnosis. KD is a vasculitis of still unknown origin occurring predominantly in infants and preschool children. KD before the age of 3 months is rare. There are only few reports about KD in the 1st month. We present a newborn who showed the cardiac symptoms of KD in the 1st week of life with coronary dilatation and myocarditis.
The diagnosis of incomplete KD should be considered not only in infants but also in newborns with signs of myocarditis and coronary abnormalities. Therapy with gammaglobulins may prevent the sequelae of coronary involvement.
新生儿早期急性心力衰竭较为罕见。通常是由窒息、严重败血症、先天性心脏畸形或病毒性心肌炎引起。川崎病（KD）作为新生儿心肌炎的病因尚未得到确诊。KD是一种病因不明的血管炎，主要发生于婴儿和学龄前儿童。3个月龄前的KD较为罕见。关于第1个月内的KD仅有少数报道。我们报告1例新生儿，在出生后第1周出现KD的心脏症状，伴有冠状动脉扩张和心肌炎。
不仅对于婴儿，对于出现心肌炎和冠状动脉异常体征的新生儿也应考虑不完全KD的诊断。使用丙种球蛋白治疗可能预防冠状动脉受累的后遗症。
