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新生儿川崎病 1 例并文献复习
冯蕾1,贺雨2,宋超1
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(1. 浙江大学医学院附属儿童医院,国家儿童健康与疾病临床医学研究中心,杭州 310052;2. 重庆医科大学附属儿童医院,国家儿童健康与疾病临床医学研究中心,儿科学重庆市重点实验室,儿童发育疾病研究教育部重点实验室,儿童发育重大疾病国家国际科技合作基地,重庆 400014)
摘要:
目的:探讨新生儿川崎病的临床特点、诊断及治疗。 方法:回顾性分析浙江大学医学院附属儿童医院新生儿科收治的 1 例新生儿川崎病患儿的临床表现、实验室检查、治疗经过,并进行文献复习。 结果:患儿,女,29 d,因发热 3 d 于 2017 年 6 月 8 日入院。 查体:双肺呼吸音粗,可及痰鸣音,四肢肢端凉,双下肢可见花斑。 辅助检查:白细胞计数 5. 27×109/ L,中性粒细胞百分比 75. 8%,血红蛋白 100 g / L,血小板 112×109/ L,超敏 C 反应蛋白 60 mg / L,胸部 X 线片提示肺炎征象。 入院后予以抗感染治疗,患儿体温仍高,颜面部出现红色皮疹,伴结膜充血,指趾端硬肿,患儿发热不退,予以丙种球蛋白静脉滴注,阿司匹林口服对症治疗,患儿病情好转,2 次心脏彩超未提示冠状动脉损害,病情好转出院。 结论:新生儿川崎病临床表现常不典型,需早期识别,早期治疗。
关键词:  新生儿  川崎病  临床表现  冠状动脉损伤  丙种球蛋白
DOI:10.13407/j.cnki.jpp.1672-108X.2023.10.010
基金项目:
A Case of Neonatal Kawasaki Disease and Literature Review
Feng Lei1, He Yu2, Song Chao1
(1. Children’ s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China; 2. Children’s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China)
Abstract:
Objective: To explore the clinical characteristics, diagnosis and treatment of Kawasaki disease in neonates. Methods: Retrospective analysis was conducted on a case of neonatal Kawasaki disease admitted into the department of neonatology of Children’s Hospital, Zhejiang University School of Medicine. The clinical manifestations, laboratory examinations, treatment course and relevant literature were reviewed. Results: The child, female, 29 d, was admitted into the hospital on Jun. 8, 2017 for 3 d of fever. Physical examination revealed coarse breath sounds in both lungs, audible rales, cool extremities, and rash on the lower limbs. Auxiliary examinations showed white blood cell count of 5. 27×109/ L, neutrophil percentage of 75. 8%, hemoglobin of 100 g / L, platelet of 112×109/ L, highly sensitive C-reactive protein of 60 mg / L, and chest X-ray suggested pneumonia. The child received anti-infective therapy upon admission, yet the fever persisted. A red rash appeared on the face, accompanied by conjunctival congestion and swelling of the fingers and toes. Intravenous immunoglobulin and symptomatic treatment with oral aspirin were administered, leading to improvement in the disease condition. Two consecutive cardiac ultrasounds did not reveal coronary artery injury, and the child was discharged with improved clinical status. Conclusion: Kawasaki disease in neonates often presents with atypical symptoms and requires early identification and treatment.
Key words:  neonate  Kawasaki disease  clinical manifestation  coronary artery injury  immunoglobulin

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