Four cases of Kawasaki syndrome complicated with myocarditis
Four cases of Kawasaki syndrome complicated with myocarditis
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DOI：
10.1253/circj.70.202
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发表时间：
2006-02-01
影响因子：
3.3
通讯作者：
Kawano, Y
中科院分区：
文献类型：
--
作者：
Yoshikawa, H;Nomura, Y;Kawano, Y
心肌炎常发生于川崎综合征（KS）的急性期，且有少数重症病例报告。4例KS心肌炎患者因严重左室功能不全（LVD）而需加用儿茶酚胺治疗。病例报告3例为年龄较大的患儿，2例合并脑病。4例患者在恢复期均出现冠状动脉异常。有1例LVD病例是由于静脉注射免疫球蛋白（IVIG）前长期严重炎症所致。其余3例患者在IVIG给药前射血分数正常，但IVIG给药后射血分数降低（42-51%），C反应蛋白水平升高。这些情况表明KS心肌炎和严重或恶化inflammation.Conclusions之间的关联，即使与以前正常的超声心动图，心脏功能的仔细观察可能是必要的KS患者，特别是年龄较大的儿童，当炎症恶化后，IVIG管理。
Background Myocarditis frequently occurs in the acute phase of Kawasaki syndrome (KS), and a few severe cases have been reported. Four cases of myocarditis in KS required additional catecholamine treatment because of severe left ventricular dysfunction (LVD).Case reports Three cases were relatively older children and 2 cases were complicated with encephalopathy. All 4 developed coronary artery abnormalities during convalescence. There was 1 case of LVD because of prolonged severe inflammation prior to administration of intravenous immunoglobulin (IVIG). The remaining 3 patients had normal values for ejection fraction before the administration of IVIG but decreased values (42-51%) and increased C-reactive protein levels after IVIG administration. These cases demonstrate an association between myocarditis in KS and severe or worsened inflammation.Conclusions Even with prior normal echocardiography, careful observation of cardiac function may be necessary for patients with KS, especially older children, when inflammation deteriorates after administration of IVIG.