以发热、黄疸为首发症状的不完全川崎病2例报告并文献复习

Incomplete Kawasaki disease with initial symptoms of fever and jaundice:a report of 2 cases and literature review

目的探讨以发热、黄疸为首发症状的不完全川崎病(IKD)的临床特征。方法回顾分析2例以发热、黄疸为首发症状的不完全KD患儿的临床资料,并复习相关文献。结果3岁9个月男性患儿及10岁女性患儿,以发热、皮肤黄染、淋巴结肿大、球结膜充血为早期主要症状,均无皮疹,后期出现指端、肛周蜕皮,并冠状动脉扩张。其中男性患儿出现动眼神经麻痹及丙种球蛋白抵抗,女性患儿出现KD休克综合征。结论以发热、黄疸为首发症状的IKD患儿,可能因症状不典型而致诊断延迟。

Objective To explore the clinical features of incomplete Kawasaki disease(IKD)with first symptoms of fever and jaundice.Method The clinical data of incomplete KD with the first symptoms of fever and jaundice in 2 cases were retrospectively analyzed,and relevant literature was reviewed.Results In two patients(3-year-and 9-month-old boy and a 10-year-old girl),the main early symptoms were fever,yellowish skin,lymphadenopathy and bulbar conjunctival hyperemia,and no rash.They presented with periungual and perianal desquamation and coronary artery ectasia at the later stage.The boy developed oculomotor palsy and gamma globulin resistance,and the girl developed KD shock syndrome.Conclusion The diagnosis in IKD children with fever and jaundice as the first symptoms may be delayed due to atypical symptoms.