Isifo seKawasaki

Isifo seKawasaki yimeko enqabileyo ebandakanya ukudumba kwemithambo yegazi. Iyenzeka ebantwaneni.

Isifo seKawasaki senzeka rhoqo eJapan, apho safunyanwa khona okokuqala. Esi sifo sibonakala rhoqo kubafana kunamantombazana. Uninzi lwabantwana abaphuhlisa le meko bancinci kuneminyaka eyi-5.

Isifo seKawasaki asiqondwa kakuhle kwaye unobangela awukaziwa. Isenokuba sisifo sokuzimela. Ingxaki ichaphazela inwebu yangaphakathi, ii-lymph node, iindonga zemithambo yegazi kunye nentliziyo.

Isifo i-Kawasaki sihlala siqala ngomkhuhlane we-102 ° F (38.9 ° C) okanye ngaphezulu ongapheliyo. Umkhuhlane uhlala uphezulu njenge-104 ° F (40 ° C). Umkhuhlane ohlala ubuncinci iintsuku ezi-5 luphawu oluqhelekileyo lokuphazamiseka. Umkhuhlane unokuhlala ukuya kuthi ga kwiiveki ezimbini. Umkhuhlane uhlala ungehli ngeedosi eziqhelekileyo ze-acetaminophen (iTylenol) okanye ibuprofen.

Ezinye iimpawu zihlala zibandakanya:

• Amagazi abomvu okanye amehlo abomvu (ngaphandle kobofu okanye amanzi)
• Ubomvu obomvu, obomvu, okanye umlomo oqhekekileyo
• Inwebu ebomvu emlonyeni
• Ulwimi "lwe-Strawberry", olunombala omhlophe elwimini, okanye amaqhuma abomvu abonakalayo ngasemva kolwimi
• Olubomvu, ukudumba kwezandla kunye neenyawo
• Isikhumba phakathi komzimba, ASIKHO njenge blister
• Ukuxubha ulusu kwindawo yesini, izandla kunye neenyawo (ubukhulu becala zijikeleze iinzipho, iintende, kunye neenyawo)
• Ukuvuvukala kwe-lymph node entanyeni (kaninzi kuphela i-lymph node idumbile)
• Intlungu edibeneyo kunye nokudumba, rhoqo kumacala omabini omzimba

Iimpawu ezongezelelweyo zingabandakanya:

• Ukucaphuka
• Urhudo, ukugabha kunye neentlungu esiswini
• Khohlela kwaye uphume impumlo

Uvavanyo lulodwa alunakufumanisa isifo seKawasaki. Uninzi lwexesha, umboneleli wezempilo uya kusiqonda esi sifo xa umntwana eneempawu ezininzi eziqhelekileyo.

Ngamanye amaxesha, umntwana unokuba nefiva ehlala ngaphezulu kweentsuku ezintlanu, kodwa ingezizo zonke iimpawu eziqhelekileyo zesi sifo. Aba bantwana banokufumanisa ukuba banesifo esingaqhelekanga seKawasaki.

Bonke abantwana abanomkhuhlane ohleli ngaphezulu kweentsuku ezi-5 kufuneka bajongwe isifo seKawasaki ngumboneleli. Abantwana abanesi sifo bafuna unyango kwangoko ukuze bafumane iziphumo ezilungileyo.

Olu vavanyo lulandelayo lunokwenziwa:

• I-x-ray yesifuba
• Gcwalisa ubalo lwegazi
• Iprotheni esebenzayo yeC (CRP)
• Izinga le-sedimentation ye-Erythrocyte (ESR)
• UFerritin
• Isalum albumin
• I-serum transaminase
• Uhlalutyo lomchamo-lunokubonisa ubofu kumchamo okanye iprotheni kumchamo
• Inkcubeko yomqala ye-streptococcus
• Echocardiogram
• Electrocardiogram

Uvavanyo olufana ne-ECG kunye ne-echocardiography lwenziwa ukujonga iimpawu ze-myocarditis, i-pericarditis, kunye nokudumba kwemithambo yegazi. Isifo samathambo kunye ne-aseptic meningitis zinokwenzeka.

Abantwana abanesifo saseKawasaki bafuna unyango esibhedlele. Unyango kufuneka luqalwe kwangoko ukuthintela ukonakala kwimithambo yegazi kunye nentliziyo.

Igamma globulin efakwa ngaphakathi lunyango olusemgangathweni. Inikwa ngeedosi eziphezulu njenge-infusion enye. Imeko yomntwana ihlala ibangcono ngaphakathi kweeyure ezingama-24 zonyango kunye ne-IV gamma globulin.

I-aspirin yedosi ephezulu ihlala inikwa kunye ne-IV gamma globulin.

Nokuba kunyango oluqhelekileyo, ukuya kuthi ga kubantwana aba-4 basenokuba neengxaki kwimithambo yegazi yabo. Kubantwana abagulayo okanye abo baneempawu zesifo sentliziyo, ukongeza ii-corticosteroids ziyacetyiswa. I-tumor necrosis factor (TNF) inhibitors enjenge-infliximab (Remicade) okanye i-etanercept (Enbrel) ayikhuthazwa kunyango lokuqala. Nangona kunjalo, kusenokubakho iimvavanyo ezingcono ukuxelela ukuba ngabaphi abantwana abaza kuxhamla kula mayeza.

Uninzi lwabantwana banokuchacha ngokupheleleyo xa isifo sibanjiwe kwaye sinyangwe kwangoko. Phantse umntwana omnye kwabali-100 basweleka ngenxa yeengxaki zentliziyo ezibangelwa sesi sifo. Abantu abanesifo seKawasaki kufuneka babe ne-echocardiogram rhoqo kwiminyaka eli-1 ukuya kwemi-2 ukujonga iingxaki zentliziyo.

Isifo seKawasaki sinokubangela ukudumba kwemithambo yegazi kwimithambo, ngakumbi imithambo yegazi. Oku kunokukhokelela kwi-aneurysm. Rhoqo, inokukhokelela kwisifo sentliziyo usemncinci okanye kamva ebomini.

Tsalela umnikezeli wakho ukuba iimpawu zesifo saseKawasaki ziyaphuhla. Ukuqhekeka, imilebe ebomvu kunye nokudumba kunye nobomvu zikhula kwiindawo ezichaphazelekileyo ezinje ngeentende zesandla kunye neenyawo. Ukuba ezi ngxaki zenzeka kunye nefiva ephezulu eqhubekayo engehli nge-acetaminophen okanye ibuprofen, umntwana wakho kufuneka ahlolwe ngumboneleli.

Akukho ndlela zaziwayo zokuthintela esi sifo.

Isifo se-lymph node syndrome; Polyarteritis yabantwana

• Isifo i-Kawasaki - i-edema yesandla
• Isifo sikaKawasaki - ukuxobuka iincam zeminwe

UAbrams JY, Belay ED, Uehara R, Maddox RA, Schonberger LB, Nakamura Y.Iingxaki zentliziyo, unyango lwangaphambili, kunye nobukrakra besifo sokuqala kwisifo seKawasaki. J Isilwanyana. Ngo-2017; 188: 64-69. IINKCUKACHA: 28619520 www.ncbi.nlm.nih.gov/pubmed/28619520.

IAmerican Academy yeZilwanyana. Isifo seKawasaki. Ku: Kimberlin DW, Brady MT, Jackson MA, Long SS, ii-eds. Incwadi ebomvu: Ingxelo ye-2018 yeKomiti yezifo eziSulelayo. Umhla wama-31. I-Itasca, IL: Iziko laseMelika labantwana; Ngo-2018: 490.

UMcCrindle BW, uRowley AH, uNewburger JW, et al. Ukuchongwa, unyango, kunye nolawulo lwexesha elide lwesifo seKawasaki: ingxelo yezenzululwazi yoochwephesha bezempilo kwiAmerican Heart Association. Ukujikeleza. Ngo-2017; 135 (17): e927-e999. IINKCUKACHA: 28356445 www.ncbi.nlm.nih.gov/pubmed/28356445.

URaees M. Cardiology. Ku: Isibhedlele iJohns Hopkins, Hughes HK, Kahl LK, eds. Incwadi yesikhokelo sikaHaretet. Umhla wama-21. IPhiladelphia, PA: Elsevier; I-2018: isahluko 7.

I-Xue LJ, Wu R, iDu GL, okqhubekayo. Iziphumo kunye nokukhuseleka kwe-TNF inhibitors kwizifo ze-Kawasaki ezinganyangekiyo ne-immunoglobulin: uhlalutyo lweemeta. Iiklinikhi Rev Ukunyangwa kwamajoni omzimba. Ngo-2017; 52 (3): 389-400. IINKCUKACHA: 27550227 www.ncbi.nlm.nih.gov/pubmed/27550227.