Abstract

The article describes a case of late diagnosis of mucocutaneous lymphonodular syndrome (Kawasaki syndrome). At the beginning of the therapy, the child had fever, conjunctivitis, stomatitis, rash, solid swelling of hands and feet, and coronaritis with the development of aneurysms. The article describes the successful use of normal human immunoglobulin for intravenous administration at a dose of 2 g/kg body weight per course in combination with acetylsalicylic acid at the dose of 80 mg/kg per day. After 3 days of treatment, the rash disappeared; limb swelling and symptoms of conjunctivitis significantly reduced; and laboratory parameters of disease activity became normal (erythrocyte sedimentation rate, C-reactive protein concentration). After 3 months, inflammation in the coronary arteries was stopped. After 6 months, a regression of coronary artery aneurysms was recorded. No adverse effects during the immunoglobulin therapy were observed.

Highlights

  • The article describes a case of late diagnosis of mucocutaneous lymphonodular syndrome (Kawasaki syndrome)

  • The article describes the successful use of normal human immunoglobulin for intravenous administration at a dose of 2 g/kg body weight per course in combination with acetylsalicylic acid at the dose of 80 mg/kg per day

  • Что у пациента с длительностью болезни 6 нед назначение иммуноглобулина позволило быстро снизить активность воспаления, а через 3 мес — купировать воспалительные изменения в коронарных артериях, обеспечить регресс аневризм, вернуть ребенка к полноценной жизни

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Summary

Introduction

The article describes a case of late diagnosis of mucocutaneous lymphonodular syndrome (Kawasaki syndrome). Учитывая длительность болезни (6 нед), развитие жизнеугрожающих осложнений (аневризмы коронарных артерий), патогенетическая терапия, согласно международным протоколам лечения синдрома Кавасаки, включала «золотой стандарт»: 10% раствор иммуноглобулина человеческого нормального для внутривенного введения (ВВИГ) в дозе 2 г/кг на курс непрерывно в течение 8–12 ч и ацетилсалициловая кислота в дозе 80 мг/кг в сут с целью противовоспалительного эффекта, с последующим снижением до 5 мг/кг в сут с целью антитромботического эффекта [1].

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Conclusion

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