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Seminarios de la Fundación Española de Reumatología
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Inicio Seminarios de la Fundación Española de Reumatología Enfermedad de kawasaki
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Vol. 7. Núm. 2.Junio 2006
Páginas 57-103
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Vol. 7. Núm. 2.Junio 2006
Páginas 57-103
DOI: 10.1016/S1577-3566(06)75082-5
Acceso a texto completo
Enfermedad de kawasaki
Visitas
8335
Fernando del Castillo Martín
Unidad de Enfermedades Infecciosas. Hospital Infantil La Paz. Madrid. España
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Bibliografía
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Resumen

La enfermedad de Kawasaki es una vasculitis sistémica de etiología desconocida que afecta principalmente a niños menores de 5 años. Es actualmente la primera causa de cardiopatía adquirida en la infancia en los países desarrollados, lo que la convierte en una enfermedad de suma trascendencia en el momento actual. No se conoce su etiología, aunque existen fuertes sospechas de que sea infecciosa. El diagnóstico se realiza por criterios clínicos de fiebre persistente de al menos 5 días de duración y 4 de 5 criterios clínicos: cambios en extremidades, exantemas polimorfos, inyección conjuntival no exudativa, cambios en los labios y la mucosa oral y adenopatías>1,5cm, habitualmente unilateral. La complicación más frecuente es la dilatación y los aneurismas de las arterias coronarias, la cual ocurre en el 20-25% de los niños no tratados. El tratamiento estándar de la enfermedad es con gammaglobulina intravenosa en dosis de 2g/kg, antes de los 10 días del comienzo de la enfermedad, más ácido acetilsalicílico oral en dosis antiinflamatorias. El riesgo de lesión coronaria en los niños tratados es del 3-5%.

Palabras clave:
Enfermedad de Kawasaki
Gammaglobulina
Aneurisma
Abstract

Kawasaki disease is a systemic vasculitis of unknow etiology that occurs predominantly in children under the age of 5 years. Kawasaki disease is the most common cause of acquired heart disease in children in the developed world. The exact cause has not yet been established but there is considerable support for it to be due to an infectious agent. The diagnosis of Kawasaki disease is based in clinical criteria: fever persisting at least 5 days and the presence of at least 4 principal features: changes of extremities, polymorphous exanthem, bilateral bulbar conjunctival injection without exudate, changes in lips and oral cavity and cervical lymphadenopathy>1.5cm, usually unilateral. The most common complication is coronary arterial aneurysm and coronay arterial dilatation that occurs in 20-25% untreated children. Standard treatment for Kawasaki disease include intravenous immunoglobulin as a single 2g/kg dose within the first 10 days and oral acetilsalycilic acid. The risk of coronary damage in treated patient is 3-5%.

Key words:
Kawasaki disease
Immunoglobulin
Coronary aneurysm
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