The Complexities of the Diagnosis and Management of Kawasaki Disease.
The Complexities of the Diagnosis and Management of Kawasaki Disease.
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DOI：
10.1016/j.idc.2015.05.006
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发表时间：
2015-09
影响因子：
4.4
通讯作者：
Rowley AH
中科院分区：
文献类型：
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作者：
Rowley AH
对于儿科医生，特别是传染病专家来说，在对任何发烧4-5天的儿童进行鉴别诊断时，考虑川崎病（KD）和兼容的临床和实验室特征是至关重要的。诊断也应考虑到任何婴儿的长期发烧和相容的实验室特征，即使在没有经典的临床症状。需要及时治疗，因为延迟或未被识别的KD可导致原本健康的儿童终身心脏病或死亡。大多数患有KD的儿童对单次静脉注射2克/公斤剂量的丙种球蛋白和口服阿司匹林有反应，但一小部分儿童需要额外的治疗来解决临床疾病。治疗的目的是预防或减少冠状动脉炎症和随后由血栓形成和/或管腔肌成纤维细胞增殖引起的冠状动脉狭窄。
It is critical for pediatricians, especially infectious diseases specialists, to consider Kawasaki Disease (KD) in the differential diagnosis of any child with fever for 4–5 days and compatible clinical and laboratory features. The diagnosis should also be considered in any infant with prolonged fever and compatible laboratory features, even in the absence of the classic clinical signs. Prompt therapy is required, because delayed or unrecognized KD can lead to lifelong heart disease or death in previously healthy children. Most children with KD respond to a single 2 gram/kg dose of intravenous gammaglobulin with oral aspirin, but a small subset require additional therapies to resolve the clinical illness. The goal of therapy is to prevent or reduce coronary artery inflammation and subsequent coronary artery stenoses from thromboses and/or luminal myofibroblastic proliferation.