儿童2年内川崎病多次复发1例报告

Five episodes of Kawasaki disease within 2 years:a case report

目的探讨儿童川崎病 （KD） 多次复发情况. 方法回顾分析1例多次复发KD患儿2年的临床资料.结果患儿, 男, 4岁.于2岁时第1次患典型KD, 无冠状动脉损伤, 以后2年内又患不完全KD共4次, 均表现为发热伴颈部淋巴结肿痛、 双侧球结膜充血、 唇红、 皲裂、 杨梅舌, 无咽痛、 咽炎、 口腔溃疡, 血常规白细胞计数、 C反应蛋白、 红细胞沉降率均升高, 颈部淋巴结超声均未见化脓性改变, 大剂量丙种球蛋白静脉输注后均退热, 每次发热持续时间为6-8 d, 相邻2次发热之间的无热间隔期约为2.5、 1.5、 4.5、 13.5个月, 临床表现和基因检测结果均不符合周期性发热、 口疮性口炎、 咽炎及颈淋巴结炎综合征 （PFAPA）. 结论儿童2年内患5次KD罕见, 需要长期随访.

Objective To explore multiple recurrence of Kawasaki disease （KD）. Methods The clinical data of one child with multiple recurrent KD in two years was retrospectively analyzed. Results A four-year boy had his frst episode of classic KD without coronary artery abnormality at 2 years old. He had since had four episodes incomplete KD within 2 years, all of which were manifested by fever accompanied with neck lymph node swelling, bilateral conjunctival congestion, red and chap lips and strawberry-like tongue. White blood cell count, C reaction protein, and erythrocyte sedimentation rate were all increased. No purulent changes of cervical lymph nodes were detected by ultrasound. After intravenous infusion with high doses of gamma globulin, the fever was brought down, and the duration of fever was 6-8 d. The fever free intervals between 2 adjacent episode were about 2.5, 1.5, 4.5, and 13.5 months. The clinical manifestations and genetic test results were not consistent with the periodic fever, aphthous stomatitis, pharyngitis, and cervical lymphadenitis syndrome （PFAPA）. Conclusion Five episodes of KD within 2 years are rare and a long-term follow-up is warranted.