Maʻi ʻo Kawasaki

ʻO ka maʻi ʻo Kawasaki kahi ʻano laha ʻole e pili ana i ka mumū o nā kīʻaha koko. Kū ʻia i nā keiki.

Kū pinepine ka maʻi ʻo Kawasaki i Iapana, kahi i ʻike mua ʻia ai. ʻIke pinepine ʻia ka maʻi i nā keikikāne ma mua o nā kaikamahine. ʻO ka hapa nui o nā keiki e hoʻomohala i kēia ʻano ma mua o 5 mau makahiki.

ʻAʻole maopopo maikaʻi ka maʻi ʻo Kawasaki a ʻaʻole ʻike ʻia ke kumu. He maʻi autoimmune paha ia. Hoʻopili ka pilikia i nā membrane mucous, lymph nodes, nā paia o nā kīʻaha koko, a me ka puʻuwai.

Hoʻomaka pinepine ka maʻi ʻo Kawasaki me ke kuni o 102 ° F (38.9 ° C) a ʻoi paha ke kiʻekiʻe i hele ʻole. ʻO ke kuni ke kiʻekiʻe ma mua o 104 ° F (40 ° C). ʻO ke kuni e mau ana ma 5 mau lā he hōʻailona maʻamau ia o ka maʻi. E mau paha ke kuni a hiki i 2 mau pule. ʻAʻole e iho pinepine ke kuni me nā maʻa maʻamau o acetaminophen (Tylenol) a i ʻole ibuprofen.

ʻO nā ʻōuli ʻē aʻe e komo pū me:

• Kahi koko a i ʻole nā ​​maka ʻulaʻula (me ka ʻole o ka pā a me ka hoʻokahe ʻana)
• ʻUlaʻula ʻulaʻula, ʻaʻā, a naha paha nā lehelehe
• Nā membrane mucous ʻulaʻula i ka waha
• ʻO ke alelo "Strawberry", me ka uhi keʻokeʻo ma ke alelo, a i ʻole nā ​​puʻupuʻu ʻula i ʻike ʻia ma ke kua o ke alelo
• ʻO nā lima ʻulaʻula, pehu o nā lima a me nā kapuwaʻi o nā wāwae
• Huehue ka ʻili i ka waena o ke kino, ʻaʻole blister-like
• ʻO ka ʻiliʻili ʻana i ka ʻili, nā lima, a me nā wāwae (ʻo ka hapanui e pili ana i nā kui, nā lima, a me nā kapuaʻi)
• Pehu nā lymph node i ka ʻāʻī (pinepine ka hoʻokahi o ka lymph node i pehu)
• ʻO kaʻeha hui a me ka pehu ʻana, pinepine ma nā ʻaoʻao ʻelua o ke kino

Hoʻohui ʻia nā hōʻailona hou aʻe:

• Huhū
• ʻO ka maʻi pākī, ka luaʻi, a me ka ʻeha o ka ʻōpū
• Ihu Cough and runny

ʻAʻole hiki i nā hoʻokolohua wale nō ke kuhi i ka maʻi ʻo Kawasaki. ʻO ka hapa nui o ka manawa, e hōʻoia ka mea mālama ola i ka maʻi ke loaʻa i kahi keiki ka hapanui o nā hōʻailona maʻamau.

I kekahi mau hihia, loaʻa paha i ke keiki kahi kuni e ʻoi aku ai ma mua o 5 mau lā, akā ʻaʻole naʻe nā hōʻailona maʻamau o ka maʻi. ʻIke ʻia paha kēia mau keiki me ka maʻi atypical Kawasaki.

ʻO nā keiki āpau me ke kuni e ʻoi aku ana ma mua o 5 mau lā e pono e nānā ʻia no ka maʻi ʻo Kawasaki e kahi mea hāʻawi. Pono nā keiki me ka maʻi i ka mālama mua no kahi hopena maikaʻi.

E hana ʻia paha kēia mau hoʻāʻo:

• Pākuʻi x-ray
• Helu piha koko
• C-reactive protein (CRP)
• Ka helu sedimentation ʻErythrocyte (ESR)
• Ferritin
• Albumin serum
• Seramin transaminase
• Urinalysis - hōʻike paha i ka pā i ka mimi a i ʻole ka protein i ka mimi
• ʻO ka moʻomeheu puʻu no ka streptococcus
• ʻEchocardiogram
• Uila uila

Hana ʻia nā hoʻāʻo e like me ECG a me echocardiography e nānā i nā hōʻailona o ka myocarditis, pericarditis, a me ka mumū o nā aʻa coronary. Hiki ke hana pū ʻia me ka maʻi aseptic a me ka aseptic meningitis.

Pono nā keiki me ka maʻi ʻo Kawasaki i ka lāʻau lapaʻau. Pono e hoʻomaka koke i ka mālama ʻana e pale i ka hōʻino ʻana i nā aʻa o ka coronary a me ka puʻuwai.

ʻO ka gamma globulin intravenous ka mālama maʻamau. Hāʻawi ʻia ia i nā koina kiʻekiʻe ma ke ʻano he infusion hoʻokahi. ʻOi aku ka maikaʻi o ke kūlana o ke keiki ma waena o 24 mau hola o ka mālama ʻana me IV gamma globulin.

Hāʻawi pinepine ʻia ka aspirin kiʻekiʻe me IV gamma globulin.

ʻOiai me ka hoʻomaʻamaʻa maʻamau, hiki i ka 1 i ka 4 mau keiki ke hoʻomohala i nā pilikia i loko o nā aʻa o lākou. I nā keiki maʻi a i ʻole nā ​​mea me nā hōʻailona o ka maʻi puʻuwai, paipai ʻia ka hoʻohui ʻana i nā corticosteroids. ʻAʻole koi ʻia nā mea hōʻemi Tumros nekrosis (TNF) e like me infliximab (Remicade) a i ʻole etanercept (Enbrel) no ka mālama mua ʻana. Eia nō naʻe, pono e loaʻa nā hoʻokolohua ʻoi aku ka maikaʻi e haʻi i nā keiki e pōmaikaʻi i kēia mau lāʻau.

Hiki i ka hapa nui o nā keiki ke ola pono ke hopu ʻia ka maʻi a mālama ʻia i ka wanaʻao. Ma kahi o 1 o 100 mau keiki i make i nā pilikia puʻuwai i hoʻokumu ʻia e ka maʻi. Pono ka poʻe i loaʻa i ka maʻi ʻo Kawasaki i ka echocardiogram i kēlā me kēia 1 a 2 mau makahiki e nānā no nā pilikia puʻuwai.

Hiki i ka maʻi ʻo Kawasaki ke hoʻoulu i nā kīʻaha koko i loko o nā aʻa, ʻo ia hoʻi nā aʻa kūpuna. Hiki i kēia ke alakaʻi i ka aneurysm. Kākaʻikahi, hiki ke alakaʻi i kahi puʻuwai puʻuwai i ka wā ʻōpio a i ʻole ma hope o ke ola.

Kāhea i kāu mea hāʻawi inā loaʻa nā ʻōuli o ka maʻi ʻo Kawasaki. Wāwahi, ʻulaʻula nā lehelehe a me ka pehu a me ka ʻulaʻula e hoʻomohala i nā wahi i hoʻopilikia ʻia e like me nā poho lima a me nā kapuwaʻi o nā wāwae. Inā kū kēia mau pilikia a me ke kuni kiʻekiʻe mau e iho ʻole me ka acetaminophen a i ʻole ka ibuprofen, pono ke nānā ʻia kāu keiki e kahi mea hāʻawi.

ʻAʻohe ala i ʻike ʻia e pale ai i kēia maʻi.

Mucocutaneous lymph node maʻi pale; Infantile polyarteritis

• ʻO ka maʻi ʻo Kawasaki - edema o ka lima
• ʻO ka maʻi ʻo Kawasaki - e ihi ana i ka manamana lima

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ʻAmelika Hui Pū ʻIa o Pediatrics. Maʻi ʻo Kawasaki. I: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Buke ʻulaʻula: Hōʻike 2018 a ke Kōmike no nā maʻi Infectious. 31st huaʻi. Itasca, IL: ʻAmelika Hui Pū ʻIa o Pediatrics; 2018: 490.

McCrindle BW, Rowley AH, Newburger JW, a me al. ʻIke, mālama, a me ka hoʻokele wā lōʻihi o ka maʻi ʻo Kawasaki: kahi ʻōlelo ʻepekema no nā ʻoihana olakino mai ka American Heart Association. Kaapuni. 2017; 135 (17): e927-e999. PMID: 28356445 www.ncbi.nlm.nih.gov/pubmed/28356445.

ʻO Raees M. Cardiology. I: ʻO ka Haukapila ʻo Johns Hopkins, ʻo Hughes HK, ʻo Kahl LK, nā ʻaoʻao. Buke Hand Harriet Lane. 21st ed. Piladelapia, PA: Elsevier; 2018: chap 7.

Xue LJ, Wu R, Du GL, et al. Ka hopena a me ka palekana o nā mea hoʻopuka TNF i ka maʻi ʻo immunoglobulin kūʻē: he meta-analysis. ʻO Clin Rev Allergy Immunol. 2017; 52 (3): 389-400. PMID: 27550227 www.ncbi.nlm.nih.gov/pubmed/27550227.