川崎病合并关节炎3例病例报告并文献复习

Kawasaki Disease Combined with Arthritis: A Report of Three Cases and Literature Review

目的:总结川崎病(Kawasaki Disease, KD)合并关节炎的临床特点及其与全身型幼年特发性关节炎(Systemic-onset Juvenile Idiopathic Arthritis, SoJIA)的鉴别要点。方法:回顾性分析3例KD合并关节炎患儿的临床资料,并结合相关文献复习进行分析。结果:3例患儿均以发热起病,其中2例为早发性关节炎,1例为晚发性关节;3例均为多关节受累,2例累及大关节;3例均在丙种球蛋白联合阿司匹林治疗的基础上,加用糖皮质激素治疗,2例关节症状缓解,1例失访。结论:KD合并关节炎的发病率有增高趋势,其发病机制仍未完全明确,疾病早期与SoJIA鉴别困难,需要临床医生提高对本病的认识,合理诊断及治疗。

Objective: To summarize the clinical characteristics of Kawasaki Disease (KD) complicated with ar-thritis and the key points of differentiation between KD combined with arthritis and Systemic-onset Juvenile Idiopathic Arthritis (SoJIA). Methods: The clinical data of three children with KD compli-cated with arthritis were retrospectively analyzed, and the pertinent literatures were reviewed. Results: All three patients had fever as the first symptom. Two patients had early-onset arthritis and the other one had late-onset arthritis. All three patients had symptoms of multiple joint disease, and large joints were involved in 2 cases. Based on gamma globulin combined with aspirin and glu-cocorticoid therapy, two of the three patients showed a relief in joint symptom and one was lost to follow-up. Conclusions: The incidence of KD combined with arthritis has an increasing trend, and its pathogenesis is still not completely clear. It is difficult to distinguish from SoJIA in the early stage of the disease. Clinicians need to improve the understanding of this disease, and make a reasonable diagnosis and treatment plan.