Kawasaki disease is growing sharply, mainly in children under 5 years old. The disease begins with fever during the first week of illness join the peculiar changes of the skin, mucous membranes, and lymphadenopathy. Skin changes are characterized by polymorphous exanthema trunk and extremities. Typical diffuse redness of the skin of palms and soles, and swelling of the thick brush.
After 10-15 days of rash onset occurs peeling skin on the fingertips and palms. Along with the rash observed in conjunctivitis, diffuse hyperemia of the mucous membrane of the lips, mouth, tongue, throat. Often there is an increase of peripheral lymph nodes, predominantly in the neck.
Among the various manifestations of C. b. Characterized as any systemic vasculitis polisindromnostyu, the main importance is coronaritis, accompanied by a narrowing and sometimes complete occlusion of the coronary arteries, the development of aneurysms. In the acute period of disease symptoms koronarita detected in approximately 40% of patients. Violations of the coronary circulation can lead to serious complications (myocardial infarction, diffuse cardio, etc.). However, many patients with coronary changes are reversible.
Other manifestations of systemic vasculitis with C. b. are arthralgia and arthritis, damage to the gastrointestinal tract, kidney, TS.NS Observed, they are not as permanent as coronaritis. In the midst of illness revealed leukocytosis, thrombocytosis, increased ESR and C-reactive protein levels are often elevated transaminases. The urine may show white blood cells, protein. In the case of koronarita observed various changes in the ECG rhythm and conduction disturbances, signs of focal or diffuse myocardial damage.
Diagnosis is based on a typical clinical picture. Increased vigilance is crucial for the possible koronarita, which usually determines the severity of C. b. and its prognosis. Therefore, required frequent electrocardiographic examination and re-conduct the two-dimensional echocardiography. In unclear cases, selective coronary angiography is shown.
Treatment in a hospital, it is recommended mainly acetylsalicylic acid 100 mg / kg per day during the period of fever, followed within a few months, give a small dose - 5 mg / kg per day. There have been reports on the effectiveness of intravenous administration of human gamma globulin (400 mg / kg per day for 4 days), the use of which rapidly suppresses fever, but according to some sources, reduces the incidence of koronarita.
The prognosis for most patients is favorable, a few months, usually comes a full recovery. In 3-5% of patients with long-preserved signs of coronary vessels. Mortality in the K. b. is 0.1-0.3%.
Among the various manifestations of C. b. Characterized as any systemic vasculitis polisindromnostyu, the main importance is coronaritis, accompanied by a narrowing and sometimes complete occlusion of the coronary arteries, the development of aneurysms. In the acute period of disease symptoms koronarita detected in approximately 40% of patients. Violations of the coronary circulation can lead to serious complications (myocardial infarction, diffuse cardio, etc.). However, many patients with coronary changes are reversible.
Other manifestations of systemic vasculitis with C. b. are arthralgia and arthritis, damage to the gastrointestinal tract, kidney, TS.NS Observed, they are not as permanent as coronaritis. In the midst of illness revealed leukocytosis, thrombocytosis, increased ESR and C-reactive protein levels are often elevated transaminases. The urine may show white blood cells, protein. In the case of koronarita observed various changes in the ECG rhythm and conduction disturbances, signs of focal or diffuse myocardial damage.
Diagnosis is based on a typical clinical picture. Increased vigilance is crucial for the possible koronarita, which usually determines the severity of C. b. and its prognosis. Therefore, required frequent electrocardiographic examination and re-conduct the two-dimensional echocardiography. In unclear cases, selective coronary angiography is shown.
Treatment in a hospital, it is recommended mainly acetylsalicylic acid 100 mg / kg per day during the period of fever, followed within a few months, give a small dose - 5 mg / kg per day. There have been reports on the effectiveness of intravenous administration of human gamma globulin (400 mg / kg per day for 4 days), the use of which rapidly suppresses fever, but according to some sources, reduces the incidence of koronarita.
The prognosis for most patients is favorable, a few months, usually comes a full recovery. In 3-5% of patients with long-preserved signs of coronary vessels. Mortality in the K. b. is 0.1-0.3%.
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