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不完整的川崎病与肌肉衰弱和膀保留:一个病例报告
Yating Sang1,2, Lili Luo3,4, Lina Qiao5,6,7
1Pediatric Intensive Care Unit, West China Second University Hospital, Sichuan University, Chengdu, China.
BMC pediatrics
|June 26, 2024
概括
本病例报告详细介绍了一名儿童的不完整的川崎病 (IKD),该病例呈现肌肉疲软和膀/肠缩,导致心脏和呼吸系统衰竭迅速发生. 早期治疗导致了有利的预后,为罕见的KD表现提供了洞察力.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 儿童心脏病学 儿童心脏病学
- 儿科神经学 儿科神经学
背景情况:
- 川崎病 (KD) 是一种严重的儿科血管炎,影响5岁以下的儿童.
- 肌肉衰弱和膀阻塞是罕见的KD表现,其潜在机制尚不清楚.
- 之前关于肌肉衰弱的KD的报道是有限的,而膀保留的KD非常罕见.
研究的目的:
- 报告一个非完整的川崎病 (IKD) 独特病例,同时出现肌肉衰弱和膀/肠缩.
- 突出罕见KD呈现的诊断和治疗方面的考虑.
- 为了解KD相关的神经肌肉和自主功能障碍的病理生理学做出贡献.
主要方法:
- 一个22个月大的孩子患有不典型的IKD症状的案例介绍.
- 临床评估包括体检,实验室测试 (肌酸激酶) 和电肌图.
- 用静脉注射免疫球蛋白,阿司匹林和类固醇治疗.
主要成果:
- 孩子出现了发烧,下肢逐渐软弱,膀/肠缩,迅速发展为心脏和呼吸系统衰竭和休克.
- 尽管没有典型的KD临床特征,但确诊了冠状动脉抽血 (CAA).
- 正常的肌酸激酶和电肌图学结果表明,虚弱的非肌肉性原因.
- 患者在治疗后的肌肉强度和整体状况显著改善.
结论:
- 这是首个报告的IKD病例,肌肉软弱和膀/肠缩.
- 尽管最初的诊断挑战和快速恶化,孩子经历了一个有利的结果,迅速治疗.
- 这一案例强调了在患有无法解释的神经肌肉和自主功能障碍的儿童中考虑KD的重要性,即使具有非典型特征.
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