A report of two cases of Kawasaki disease treated with plasma exchange
A report of two cases of Kawasaki disease treated with plasma exchange
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DOI：
10.1111/j.1744-9987.2008.00566.x
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发表时间：
2008-04-01
影响因子：
1.9
通讯作者：
Yokota, Shumpei
中科院分区：
文献类型：
--
作者：
Harada, Tomonori;Ito, Shuichi;Yokota, Shumpei
川崎是一种病因不明的全身性血管炎，主要发生在婴儿和幼儿。预防其心血管表现，特别是冠状动脉病变非常重要。早期静脉注射免疫球蛋白治疗可以减少心血管后遗症，但有些患者对这种治疗没有反应，并且他们有很高的冠状动脉病变发生率。另一方面，急性心力衰竭是罕见的川崎。我们报告的情况下，两名患者持续发热和休克，即使静脉注射免疫球蛋白治疗。在这两种情况下，血浆置换可能降低了冠状动脉病变的风险，并证明对急性心力衰竭伴儿茶酚胺难治性休克有效;但这种改善的机制仍不清楚。
Kawasaki disease is a generalized vasculitis of unknown etiology that occurs predominantly in infants and young children. It is very important to prevent its cardiovascular manifestations, especially coronary artery lesions. Early treatment with intravenous immunoglobulin reduces cardiovascular sequelae, but some patients do not respond to this treatment, and they have a high incidence of coronary artery lesions. On the other hand, acute heart failure is rare in Kawasaki disease. We report on the cases of two patients with persistent fever and shock even after intravenous immunoglobulin therapy. In both cases, plasma exchange may have reduced the risk of coronary artery lesions and proved effective against acute heart failure with catecholamine-refractory shock; yet the mechanism of this improvement remains unclear.