NEJM:一例草梅舌----川崎病罕见的症状

2015-07-31 MedSci MedSci原创

一名8岁的小女孩来院就诊,院前其已经出现发热和皮疹7天余。体格检查可见,其全身弥漫性黄斑皮疹、口唇裂隙和草莓舌,体温达39℃。此外,双眼存在非渗出性结膜充血、颈部淋巴结部分肿大以及掌跖红斑,手中轻度水肿,甲周和脱屑。心功能检查未见异常。实验室检查结果显示白细胞增多,白细胞计数为13000/每立方毫米(正常范围,3500–10500)和红细胞沉降率升高,每小时80毫米(正常范围,0至29)。血小板计

一名8岁的小女孩来院就诊,院前其已经出现发热和皮疹7天余。


体格检查可见,其全身弥漫性黄斑皮疹、口唇裂隙和草莓舌,体温达39℃。此外,双眼存在非渗出性结膜充血、颈部淋巴结部分肿大以及掌跖红斑,手中轻度水肿,甲周和脱屑。心功能检查未见异常。



实验室检查结果显示白细胞增多,白细胞计数为13000/每立方毫米(正常范围,3500–10500)和红细胞沉降率升高,每小时80毫米(正常范围,0至29)。血小板计数和心电图及超声心动图结果均正常。

根据该女孩的临床症状及检查结果,初步诊断其患上的是川崎病。

入院后,该女孩接受采用阿司匹林和免疫球蛋白进行治疗。8个星期后对其进行定期随访。

川崎病,又称皮肤粘膜淋巴结综合症,是一种以全身血管炎变为主要病理的急性发热性出疹性小儿疾病。最常见于5岁以下的儿童,一般最容易影响到的是中小动脉。对于此疾病,早期诊断准确和治疗性干预可以大大地降低冠状动脉病变的风险。

目前,尚没有针对川崎病的特异性诊断方法,诊断川崎病的方法仍是通过根据其临床表现和鉴别性诊断来排除其他可能性的疾病,包括其他感染性的儿童皮疹和药物过敏。

原始出处:

Kole A, Chandakole D.Strawberry Tongue.N Engl J Med. 2015 Jul 30;373(5):467.

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    2016-04-30 吴玲

    见识到了

    0

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    2015-08-18 张荣伟

    第一次见这个病

    0

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    2015-08-02 syscxl
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    2015-08-01 Jianghuiqin

    学习了~不过草莓舌看得密集恐惧了!

    0

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