SINDROM KAWASAKI
Tri Puspita Prihatinningrum A.F, Satya Wydya Yenny
ABSTRAK
!" #$ #%& # '()# ! # $&((("$ terdiagnosis kurang dari 100 per tahun dan misdiagnosis sering terjadi. Oleh karena itu, penting # "" # !*# klinis mayor sindrom Kawasaki terdiri atas demam, vaskulitis multisistem akut, eksantema +" -###" /- " tangan dan telapak kaki atau deskuamasi periungual, serta limfadenopati servikal nonsupuratif 234"&56 ! $## $ 7 &84&) # #9 $ $ # # # jangka panjang terhadap gejala sisa koroner. Tatalaksana sindrom Kawasaki adalah Intra Venous
2:*6 " -# :* !5-#&-#34;5-# #:*#4(! penyakit.
Kata kunci: Sindrom Kawasaki, insidens, diagnosis
ABSTRACT
!;$ 5$5"5$--5 - 5 &$8"!'()-;5 5- -55 5 5-!;$ 5 #&(((5"# cases diagnosed were less than 100/year and misdiagnosis are common. It is important to know "$" 5 5 - -!;$ 5 5--!;$ -"5$5"$5= "# ## =5 " / "$ > " 5 5$ $2?4& 56!;$ 5 55> 5 5 $ 5 55 &84&) 5 #5 $ 5 $ 8 5 $>@ -!;$ 5 - # 2:*6 "# $ --5 -5# -:* > good, except when there is coronary arterial aneurism and if IVIG therapy is initiated more than 10 days from onset of the disease.
Keywords:
Korespondensi:
!"#$
PENDAHULUAN
*+*,-. / 000.& 01 0&!#$ " eritema pada telapak & & . & + 34 ,1-4
9 *-!;atau
mucocutaneous lymph node syndrome * - 0 ; =<;=>1-4
* - ?;? * - 0 - *-
);
@ * 0 * A<> & - * - B- - ** 0 @.
- *1,4,6,7
EPIDEMIOLOGI
* -? E;4= * 4( ; =<F 4<<<<< / -G?1H ;$-4$4<-* 4444<<<<</-*0 00*-1 -E<-;? & - - =<<< EA 4<<<<</-%* 4AEE=<<= 4E4<<<<<
1,2,6-8
Insidens SK per tahun di Indonesia diperkirakan 4<< - *
=(*-pada Simposium Sindrom Kawasaki Internasional ke-8 di
*@=<<5*
9-?H-* M@00B =<<A-N. =<4); -9* 9-+ HMH*M@0 ,
ETIOLOGI DAN PATOGENESIS
%* 090 -* . * & - 0 & & * 0 0-sel @8 O@P !& ..9 +Q,;4
tumor necrosis factor +N",;RQ;E
vascular endothelial growth factor
9 +# 4AA<,Q;=+Q; =H,*Q;=H 0 0. & * - -;.; Q;4N";R&+N",;T4EA
Q * 0 &.%;9
$5 "5B, dan human adenovirus * -4)*
Staphylococcus aureus pada 11 pasien dan streptokokus =4EA4<
GEJALA KLINIS Gejala umum
-(<-W 1,2,11
Manifestasi nonmukokutan
00. .W. . .? 00 &
- 1,11
9 0 * & ;=;)- -E> X & +& &,)<>
0- *2,4,6
0- . <>Q& 0 0 - &X *--&&0.&+ >*,+. ,. & &=)E44
Gejala mukokutan
Erupsi polimorfik, dermatitis skarlatiniformis pada - -00. &.0 * -&& .95 H8*
&4,6
Erupsi kulit
eritematosa polimorfik, erupsi difus makular, skarlatiniformis, $ -8 +, & ? % 0 - - . % -
&H* - 0 - - % F<;A<> -Q& 0&-&.% 0-&
-;(1,6,11
Deskuamasi periungual
@ 0;0 -& 4-) - Q @ @ &
1,6
Edema dan eritema tangan dan kaki
%0 % - % & - -- & 0F<;A<>6,11
Kelainan mukosa orofaring
& * ; 1 &
W&!#$
tongue - 0 F<;A<>6,11
Kelainan kuku
9;
Kelainan kutan yang jarang
?=*X& <<<<< - 4<<<<<<!) & - =;) menunjukkan temuan spesifik, terdapat edema papila & & American Heart Association
+?G?, & * ; = ;E ;F * Pemeriksaan Magnetic Resonance Imaging (MRI) dan
dan cardiac ultrasound scanning15
DIAGNOSIS
@ * ?G? 0 4@* 0
1
Tabel 1. Kriteria diagnostik sindrom Kawasaki
@-
-0-SK incomplete
*0 1,14
DIAGNOSIS BANDING
@ * - scarlet fever,
Staphylococcal Scalded Skin Syndrome (SSSS), infeksi .+ &.,%M&
+%M, *.;- +**,!#$
tongue&.&
0 !#$ 0
0 * + <> , **%M** %M - & X **** 0 & . -0.
-4)44
PENATALAKSANAAN
G -@* 4<-- 0 % 0G *
1,6
Penatalaksanaan topikal
- & * &
1,6
Penatalaksanaan sistemik
*#
+ZX, -W 0 ZX = ! & 4<;4= 0 4< - 0 *4<> ZX ZX4! ZX - &
--12,16-18
? &W ? F<;4<< !- 4--);!E;F +=<<F,
8 5$ $$
=-ZX
*4=4A
* - . 0 & * - ; * &. ZX - ZX - ZX - * 4)F4E4F
KOMPLIKASI
* . &00 --4* 0&Q0 ;4> 0 0 * 0 ;9 0 0
7,20
Q . * & @ 0 0 &1 difus atau parut fokal pada daerah iskemia miokardial atau &9&G+?=<4),-& * =<<-@ =<4= - A ? *4( @ 0 =) =4 4 4 & Xg;M % +M =<44, *;
&.20
PROGNOSIS
4< -infark miokardium, sudden death 0 &* tahun ke tahun, namun kasus SK di Indonesia masih )&*& ?*M?Vasculitis disorders@$?*M?
\!B5 55$`8J90$
( G*;QM;O-G;OG*;O[M;GEpidemiology of !b 5- # - 5 #$$$ 5 =<4)y4E)$4=E;)4 F *HON?=<4=yA$=z A qMQ@qM*-.MEvidence for the involvement
-#5 "5" ! syndrome"%M*M Q=<<<y4A=$4;(
4<9*M."-?GMB*-OX%G
# 8N5 5 !!$
Arthritis and rheumatism.4AA<y))$4)(4;E
44%N9[@[Kawasaki syndrome?@
4AA<y)4$E4;(4
4=M?*-;??Other viral diseases@$9Q gg Q H H @ % ;= *$ M ;%.y=<<F
4)-[XMHAdult Kawasaki syndrome.9@4AA)y 4=A$))<;)
4G@ "GZX""OZIncreased detection rate of Kawasaki disease using new diagnostic algorithm, including early use of echocardiography=<<Ay4$EA;AA4 4 Q Q? X O ;? Q Z {;
H$-5 5! &' pediatric patients9*=<<Ay(E$F4;
4E -*0B-N?G `-+55$- # - -5 $ $ # ! ` $6b " 8#"# 8 Q=<4=y)(A$4E4)z=< 4(9&GG-NX- M"Q9-[M?-M
Cardiovascular involvement in Kawasaki disease in Algerian children: our = 55-H5=<4)y4<E$((;F 4F9 * Kawasaki disease: etiology, pathogenesis, and treatment
O.OM=<<=yEA$EA;(F
