急性川崎病的关节炎表现

作     者：GongG.W.K. McCrindle B.W. Ching J.C. Yeung R.S.M 贺莉 

作者机构：The Divisions of Rheumatology and CardiologyThe Hospital for Sick Children Divisions of Cancer Research and Population Health Science Toronto OntCanada Dr. 

出 版 物：《世界核心医学期刊文摘（儿科学分册）》 (Dkgest of the World Latest Medical Information)

年 卷 期：2006年第2卷第11期

页      面：28-29页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：川崎病 静脉免疫球蛋白 关节受累 临床病程 药物治疗 临床评估 炎性标志物 影像学检查 全身炎症 人 

摘      要：Objective: To define the prevalence, pattern, and clinical course of arthritis presenting at the time of diagnosis of Kawasaki disease. Study design: A single-center, retrospective study of 414 consecutive patients diagnosed with Kawasaki disease between January 1997 and December 2002 was performed. Standardized clinical assessments, laboratory and imaging test results, and treatment regimens were reviewed. The clinical, laboratory, treatment response,and coronary outcome data were analyzed for children with and without arthritis. Results: The prevalence of arthritis was 7.5%(31/414). In the 31 children with arthritis,55%had oligoarticular involvement and 45%had polyarticular involvement. In both of these groups, the large joints were predominantly involved. Some 88%of the children with arthritis responded to standard intravenous immunoglobulin therapy for acute Kawasaki disease and did not require additional medications. The children with arthritis had significantly increased levels of inflammatory markers, but their demographical and clinical features were otherwise similar to those of the children without arthritis, including coronary outcome, with the same proportion(13%) of children from each group having coronaryartery lesions (z-score ≥2.5). Conclusions: Arthritisis a short-lived phenomenon included in the clinical spectrum of acute Kawasaki disease. Children with arthritis have evidence of increased systemic inflammation but otherwise share the same clinical features, response to treatment, and coronary outcomes as patients without *** cases of arthritis resolve without additional therapeutic intervention.