Isifo seKawasaki

Isifo seKawasaki yisimo esingajwayelekile esifaka ukuvuvukala kwemithambo yegazi. Kwenzeka ezinganeni.

Isifo seKawasaki sivela kaningi eJapan, lapho satholwa khona okokuqala. Lesi sifo sibonakala kaningi kubafana kunamantombazane. Iningi lezingane eziba nalesi simo zingaphansi kweminyaka yobudala engu-5.

Isifo seKawasaki asiqondakali kahle futhi imbangela ayikaziwa. Kungaba isifo se-autoimmune. Inkinga ithinta ulwelwesi lwamafinyila, ama-lymph node, izindonga zemithambo yegazi, nenhliziyo.

Isifo seKawasaki siqala ngokushisa okungu-102 ° F (38.9 ° C) noma ngaphezulu okungapheli. Umkhuhlane uvame ukuphakama u-104 ° F (40 ° C). Imfiva ehlala okungenani izinsuku ezi-5 iyisibonakaliso esivamile sokuphazamiseka. Umkhuhlane ungahlala kuze kube amasonto ama-2. Imfiva ngokuvamile ayihli ngemithamo ejwayelekile ye-acetaminophen (iTylenol) noma ibuprofen.

Ezinye izimpawu zivame ukufaka:

• Amehlo abomvu wegazi noma abomvu (ngaphandle kobomvu noma amanzi)
• Izindebe ezibomvu ngokukhanyayo, eziqhwalekile noma eziqhekekile
• Izinambuzane ezibomvu emlonyeni
• Ulimi "lwe-Strawberry", olunezingubo ezimhlophe olimini, noma izigaxa ezibomvu ezibonakalayo ngemuva kolimi
• Izintende ezibomvu, ezivuvukile zezandla kanye namathe ezinyawo
• Ukuqhuma kwesikhumba maphakathi nomzimba, HHAYI okufana nebhamuza
• Ukuxebuka isikhumba endaweni yangasese, ezandleni nasezinyaweni (ikakhulu ezizungeze izinzipho, izintende, namathe)
• I-lymph node evuvukile entanyeni (imvamisa i-lymph node eyodwa kuphela evuvukile)
• Ubuhlungu obuhlangene nokuvuvukala, imvamisa ezinhlangothini zombili zomzimba

Izimpawu ezingeziwe zingabandakanya:

• Ukuthukuthela
• Uhudo, ukuhlanza, nobuhlungu besisu
• Ukukhwehlela nekhala eligijimayo

Ukuhlolwa kukodwa akukwazi ukuthola isifo seKawasaki. Isikhathi esiningi, umhlinzeki wezokunakekelwa kwempilo uzoxilonga lesi sifo lapho ingane inezimpawu eziningi ezivamile.

Kwezinye izimo, ingane ingaba nomkhuhlane ohlala izinsuku ezingaphezu kwezingu-5, kodwa hhayi zonke izimpawu ezivamile zesifo. Lezi zingane zingatholakala zinesifo esingajwayelekile seKawasaki.

Zonke izingane ezinomkhuhlane ohlala izinsuku ezingaphezu kwezingu-5 kufanele zihlolwe umhlinzeki ukuthi azinaso yini isifo seKawasaki. Izingane ezinesifo zidinga ukwelashwa kusenesikhathi ukuze zibe nomphumela omuhle.

Ukuhlolwa okulandelayo kungenziwa:

• I-x-ray yesifuba
• Qedela ukubalwa kwegazi
• Amaprotheni asebenza ngoku-C (CRP)
• Izinga le-sedimentation ye-Erythrocyte (ESR)
• UFerritin
• I-serum albumin
• I-serum transaminase
• I-Urinalysis - ingakhombisa ubomvu emchameni noma amaprotheni emchameni
• Isiko lomqala le-streptococcus
• I-Echocardiogram
• I-Electrocardiogram

Ukuhlolwa okufana ne-ECG ne-echocardiography kwenziwa ukubheka izimpawu ze-myocarditis, i-pericarditis, nokuvuvukala kwemithambo yenhliziyo. I-arthritis ne-aseptic meningitis nayo ingenzeka.

Izingane ezinesifo saseKawasaki zidinga ukwelashwa esibhedlela. Ukwelashwa kufanele kuqalwe khona manjalo ukuvimbela ukulimala kwemithambo yenhliziyo nenhliziyo.

I-gamma globulin efakwa ngaphakathi iyindlela yokwelashwa ejwayelekile. Inikezwa ngemithamo ephezulu njengokumnika okukodwa. Isimo sengane sivame ukuba ngcono kakhulu kungakapheli amahora angama-24 ekwelashwa nge-IV gamma globulin.

I-aspirin yedosi ephezulu ivame ukunikezwa kanye ne-IV gamma globulin.

Ngisho nangokwelashwa okujwayelekile, kuze kufike kwengane eyodwa kwezine ezinganeni zisengaba nezinkinga emithanjeni yazo yemithambo yegazi. Ezinganeni ezigulayo noma kulabo abanezimpawu zesifo senhliziyo, kunconywa ukwengeza i-corticosteroids. I-Tumor necrosis factor (TNF) inhibitors efana ne-infliximab (Remicade) noma i-etanercept (Enbrel) ayinconyelwa ukwelashwa kokuqala. Kodwa-ke, kusadingeka ukuthi kube nokuhlolwa okungcono okutshela ukuthi yiziphi izingane ezizosizakala ngale mithi.

Iningi lezingane lingalulama ngokuphelele lapho lesi sifo sibanjwe futhi selashwe kusenesikhathi. Cishe ingane eyodwa kwezingu-100 ibulawa yizinkinga zenhliziyo ezidalwa yilesi sifo. Abantu abebenezifo zeKawasaki kufanele babe ne-echocardiogram njalo eminyakeni eyi-1 kuye kwengu-2 ukuhlola izinkinga zenhliziyo.

Isifo seKawasaki singadala ukuvuvukala kwemithambo yegazi emithanjeni yegazi, ikakhulukazi imithambo yegazi. Lokhu kungaholela ku-aneurysm. Imvamisa, kungaholela ekuhlaselweni yinhliziyo usemncane noma kamuva empilweni.

Shayela umhlinzeki wakho uma kuvela izimpawu zesifo saseKawasaki. Izindebe eziqhekekile, ezibomvu nokuvuvukala nokubomvu kubangelwa ezindaweni ezithintekile njengezintende nezinyawo. Uma lezi zinkinga zenzeka kanye nomkhuhlane omkhulu oqhubekayo ongehli nge-acetaminophen noma ibuprofen, ingane yakho kufanele ihlolwe ngumhlinzeki.

Azikho izindlela ezaziwayo zokuvimbela lesi sifo.

Isifo se-lymph node syndrome; I-polyarteritis yezinsana

• Isifo se-Kawasaki - i-edema yesandla
• Isifo sikaKawasaki - ukuxebuka kwaminwe

Abrams JY, Belay ED, Uehara R, Maddox RA, Schonberger LB, Nakamura Y.Izinkinga zenhliziyo, ukwelashwa kwangaphambilini, kanye nobukhulu besifo sokuqala esifo seKawasaki. J Pediatr. 2017; 188: 64-69. I-PMID: 28619520 www.ncbi.nlm.nih.gov/pubmed/28619520.

I-American Academy Yezingane. Isifo seKawasaki. Ku: Kimberlin DW, Brady MT, Jackson MA, Long SS, ama-eds. Incwadi Ebomvu: Umbiko we-2018 weKomidi Lezifo Ezithathelwanayo. Umhlaka 31. I-Itasca, IL: I-American Academy Yezingane; 2018: 490.

UMcCrindle BW, uRowley AH, uNewburger JW, et al. Ukuxilongwa, ukwelashwa, nokuphathwa kwesikhathi eside kwesifo i-Kawasaki: isitatimende sesayensi sabasebenzi bezempilo abavela e-American Heart Association. Ukujikeleza. 2017; 135 (17): e927-e999. I-PMID: 28356445 www.ncbi.nlm.nih.gov/pubmed/28356445.

URaees M. Cardiology. Ku: Isibhedlela iJohns Hopkins, Hughes HK, Kahl LK, eds. IHarriet Lane Handbook. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2018: isahluko 7.

I-Xue LJ, i-Wu R, i-Du GL, et al. Umphumela nokuphepha kwama-TNF inhibitors ku-immunoglobulin-resistant Kawasaki Disease: a meta-analysis. I-Clin Rev Ukungezwani komzimba ne-Immunol. 2017; 52 (3): 389-400. I-PMID: 27550227 www.ncbi.nlm.nih.gov/pubmed/27550227.