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Aseptic Meningoencephalitis in Children with Kawasaki Disease

机译:川崎病患儿的无菌性脑膜脑炎

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Objective: To describe the clinical presentations, diagnosis and therapy of 15 Kawasaki disease (KD) patients with aseptic meningoencephalitis. Methods: Patients' medical records were retrospectively reviewed with reference to age, gender, duration of disease, clinical presentation, laboratory findings, diagnosis and therapy. Results: There were 10 males and 5 females with an average age of 38.2 months. Headache was noted in 10 patients (66.67%), vomiting in 6 (40.0%), seizures in one (6.67%). Thirteen (86.67%) showed central nervous system (CNS) features in the acute phase while 2 patients showed headache or vomiting in the subacute phase. Elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were noted in all patients, thrombocytosis in 9 (60.0%), elevated aminoleucine transferase and/or aspartate aminotransferase in 2. Also, CSF pleocytosis were noted in 9 patients. These patients had a good response to intravenous immunoglobulin (IVIG) therapy. No complications were noted in the follow-up. Conclusion: KD, like many other vasculitic diseases, can sometimes involve the CNS and present with irritability, lethargy, headache, vomiting and seizures. Aseptic meningoencephalitis should be suspected especially in KD patients with persisted elevated CRP, ESR, and CNS symptoms.
机译:目的:描述15例川崎病(KD)无菌性脑膜脑炎的临床表现,诊断和治疗方法。方法:根据年龄,性别,疾病持续时间,临床表现,实验室检查结果,诊断和治疗,对患者的病历进行回顾性审查。结果:男10例,女5例,平均年龄38.2个月。头痛10例(66.67%),呕吐6例(40.0%),癫痫1例(6.67%)。 13例(86.67%)在急性期显示中枢神经系统(CNS)功能,而2例患者在亚急性期显示头痛或呕吐。所有患者的C反应蛋白(CRP)和红细胞沉降率(ESR)均升高,其中有9例(60.0%)有血小板增多症,有2例有氨基亮氨酸转移酶和/或天冬氨酸转氨酶升高。此外,有9例患者出现了CSF的细胞增多。这些患者对静脉免疫球蛋白(IVIG)治疗有良好的反应。随访中未发现并发症。结论:KD像许多其他血管疾病一样,有时会累及中枢神经系统,表现为烦躁,嗜睡,头痛,呕吐和癫痫发作。尤其是持续CRP,ESR和CNS症状持续升高的KD患者,应该怀疑是无菌性脑膜脑炎。

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