Tratamiento y complicaciones de la enfermedad de kawasaki en pacientes pediótricos
DOI:
https://doi.org/10.23857/dc.v8i2.2730Palabras clave:
Kawasaki, vasculitis, arterias coronarias, linfodenopatÃas, aneurismas.Resumen
La patología de Kawasaki es una vasculitis que en su mayoría de casos compromete las arterias coronarias y puede desarrollarse en niños a temprana edad. Se describe por presentar síntomas como fiebre prolongada, exantema, conjuntivitis, inflamación de las mucosas y linfodenopatías, trayendo como consecuencia en muchos casos aneurismas en las arterias coronarias y a su vez puede causar infarto de miocardio. El diagnóstico se fundamenta en criterios clínicos; una vez determinada la enfermedad, se realiza un ecocardiograma. El tratamiento consiste en aspirina e inmunoglobulina IV. Es importante hacer un diagnóstico precoz y un tratamiento oportuno que evite llegar ocasionar complicaciones que pongan en riesgo la vida del paciente.
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McCrindle BW, Rowley AH, Newburger JW,Burns JC, Bolger AF, Gewitz M, et al. Diagnosis,treatment, and long-term management of Kawasaki disease: A scientific statement for health professionals from the American Heart Association. Circulation. 2017;135:927-99.
Barrios Tascón A, Centeno Malfaz F, Rojo Sombrero H, Fernández-Cooke E, Sánchez-Manubens J,Pí©rez-Lescure Picarzo J, et al. National consensus on the cardiological treatment and follow-up ofKawasaki disease. An Pediatr (Barc). 2018;89:188.e1-188.e22.
Makino N, Nakamura Y, Yashiro M, Kosami K,Matsubara Y, Ae R, et al. The nationwide epidemiologic survey of Kawasaki disease in Japan,2015-2016. Pediatr Int. 2019;61(4):397-403.
Holman RC, Curns AT, Belay ED, Steiner CA,Schonberger LB. Kawasaki syndrome hospitalizations in the United States, 1997 and 2000.Pediatrics. 2003;112:495-501.
Sánchez-Manubens J, Antón J, Bou R, Iglesias E,Calzada-Hernández J. Incidence, epidemiology and clinical features of Kawasaki disease in Catalonia,Spain. Clin Exp Rheumatol. 2016;34:S139-44.
Fujita Y, Nakamura Y, Sakata K, Hara N, KobayashiM, Nagai M, et al. Kawasaki disease in families. Pediatrics. 1989;84:666-9.
Rodó X, Curcoll R, Robinson M, Ballester J, Burns JC, Cayan DR, et al. Tropospheric winds from northeastern China carry the etiologic agent of Kawasaki disease from its source to Japan. Proc Natl Acad Sci U S A. 2014;111:7952-7.
Rowley AH, Baker SC, Orenstein JM, Shulman ST. Searching for the cause of Kawasaki diseasecytoplasmic inclusion bodies provide new insight. Nat Rev Microbiol. 2008;6:394-401.
De Graeff N, Groot N, Ozen S, Eleftheriou D, Avcin T, Bader-Meunier B, et al. European consensusbased recommendations for the diagnosis and treatment of Kawasaki disease – the SHARE initiative. Rheumatology. 2018; 58(4):672-82.
Kobayashi T, Saji T, Otani T, Takeuchi K, Nakamura T, Arakawa H, et al. Efficacy of immunoglobulin plus prednisolone for prevention of coronary artery abnormalities in severe Kawasaki disease (RAISE study): a randomised, open-label, blindedendpoints trial. Lancet. 2012;379:1613-20.
Chen S, Dong Y, Kiuchi MG, Wang J, Li R, Ling Z, et al. Coronary Artery Complication in Kawasaki Disease and the Importance of Early Intervention. JAMA Pediatr. 2016;170:1156.
Hamada H, Suzuki H, Onouchi Y, Ebata R, Terai M, Fuse S, et al. Efficacy of primary treatment with immunoglobulin plus ciclosporin for prevention of coronary artery abnormalities in patients with Kawasaki disease predicted to be at increased risk of non-response to intravenous immunoglobulin (KAICA): a randomised co. Lancet. 2019;393:1128-37.
Mori M, Hara T, Kikuchi M, Shimizu H, Miyamoto T, Iwashima S, et al. Infliximab versus intravenous immunoglobulin for refractory Kawasaki disease: a phase 3, randomized, open-label, activecontrolled, parallel-group, multicenter trial. Sci Rep. 2018;8:1994.
Tremoulet AH, Jain S, Jaggi P, Jimí©nez-Fernández S, Pancheri JM, Sun X, et al. Infliximab for intensi fication of primary therapy for Kawasaki disease: a phase 3 randomised, double-blind, placebocontrolled trial. Lancet. 2014;383:1731-8.
Kone-Paut I, Cimaz R, Herberg J, Bates O, Carbasse A, Saulnier JP, et al. The use of interleukin 1 receptor antagonist (anakinra) in Kawasaki disease: A retrospective cases series. Autoimmun Rev.2018;17:768-74.
Paredes N, Mondal T, Brandí£o LR, Chan AKC. Management of myocardial infarction in childrenwith Kawasaki disease. Blood Coagul Fibrinolysis. 2010;21:620-31.
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