Assuntos
Fibrose Cística , Adolescente , Feminino , Humanos , Fibrose Cística/tratamento farmacológico , Aminofenóis/uso terapêutico , Benzodioxóis/uso terapêutico , Combinação de Medicamentos , Pirazóis/uso terapêutico , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Mutação , Agonistas dos Canais de Cloreto/uso terapêuticoRESUMO
This report describes the case of a 29-day-old infant with Kawasaki's disease who presented in extremis with multiple coronary aneurysms and coronary thromboses, myocardial ischemia, and congestive heart failure. The infant successfully underwent emergent coronary thrombolysis with tissue plasminogen activator.
Assuntos
Fibrinolíticos/uso terapêutico , Síndrome de Linfonodos Mucocutâneos/tratamento farmacológico , Terapia Trombolítica/métodos , Ativador de Plasminogênio Tecidual/uso terapêutico , Aspirina/uso terapêutico , Angiografia Coronária , Trombose Coronária/tratamento farmacológico , Trombose Coronária/etiologia , Ecocardiografia , Eletrocardiografia , Tratamento de Emergência , Aneurisma Cardíaco/tratamento farmacológico , Aneurisma Cardíaco/etiologia , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/etiologia , Humanos , Recém-Nascido , Masculino , Síndrome de Linfonodos Mucocutâneos/complicações , Isquemia Miocárdica/tratamento farmacológico , Isquemia Miocárdica/etiologiaRESUMO
Kawasaki disease (KD) is a systemic vasculitis that predominantly affects infants and young children. Asian race has been described as an important factor for the development of this disease. We reported our experience in a cohort of patients with KD. Clinical and laboratory data from initial presentation and follow-up visits were reviewed in 88 patients with KD treated at Children's Hospital of New Orleans between March 1993 and November 2004. Forty-nine (56%) patients were African American, 35 (40%) Caucasian, two (3%) Asian and two (3%) Hispanic. Coronary artery aneurysms (CAAs) were detected in 15 (17%) patients. CAAs were less frequent in African-American patients compared to Caucasians [relative risk (RR)=0.2, 95% CI: 0.04400-0.8405, p=0.0164]. Eighty-three patients responded to one dose of intravenous human immunoglobulin (IVIG), five patients responded to a second infusion of IVIG, and two who were IVIG resistant responded only following methylprednisolone pulse. Hemoglobin (Hb) levels of <10 g/dl and presence of polymorphic rash were significantly correlated with development of CAAs. No deaths were observed.