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KD is an acute, self-limited febrile illness. Although significant long-term sequelae are confined to the coronary arteries, multiple other organs and tissues are inflamed during the acute illness and causing clinical symptoms. Likewise, irritability and a culture-negative pleocytosis of the cerebrospinal fluid in infants with prolonged fevers suggest that aseptic meningitis may develop in patients with KD. But it is usually overlooked. Common complications of nervous system in KD children include: aseptic meningitis as the most common one, seizures, temporary hemiplegia, facial paralysis, ataxia, hearing impairment, visual abnormalities, and behavioral abnormalities can also be associated (Alves et al., Rev Assoc Med Bras 57(3):299–300, 2011; Poon et al., Hong Kong Med J 6(2):224–226, 2000; Knott et al., Am J Otolaryngol 22(5):343–348, 2001). Neurological involvement in children with KD may be due to ischemic effects of small vessel inflammation which cause neuritis, ischemia, and increased intracranial pressure. The symptoms of abducens nerve palsy in some children with KD recovered after 2–6 weeks of treatment (Amano and Hazama, Acta Pathol Jpn 30(3):365–373, 1980). Histopathological examination of KD nervous system showed edema, necrosis, glial cell hyperplasia, lymphocyte invasion, etc. (Guven et al., Pediatr Int 52(2):334, 2010; Rodriguez-Lozano et al., Allergol Immunopathol (Madr) 42(1):82–83, 2014). In our department, aseptic meningitis is the most common one. We saw abduction nerve paralysis in one KD patient, and abnormal EEG lasted over 4 months in another patient. In most of the children, neurological impairments were recovered within one month. |
