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Lebih akrab dengan Penyakit KAWASAKI …

Posted by rudiwp on February 26, 2008

Assalamu’alaikum wr.wb.

Mungkin sebagian kita orang Indonesia telah akrab dengan kata Kawasaki. Ya, minimal langsung menunjuk kepada “Kawasaki Ninja”, misalnya …salah satu seri sepeda motor keluaran Kawasaki, merek yang cukup terkenal di Indonesia …Selain itu ternyata ada juga penyakit yang namanya Kawasaki, Kawasaki Disease. Apa anda sudah mengenalnya? Kalau belum, luangkan waktu anda barang 5 menit untuk menyimak informasi ini, ok?

Barangkali ada diantara man-teman kita yang sedang berdomisili di Jepang yang sudah “dengan terpaksa” harus berkenalan dengan ini penyakit. Mengapa “dengan terpaksa”? Ya, karena kebetulan putra/putri kecilnya sedang mendapat cobaan terkena penyakit ini. Karena memang kata para ahlinya, penyakit ini cenderung menyerang bayi dan anak Balita (usia di bawah 5 tahun).

Untuk itu bagi para Bapak-Ibu yang putra/putrinya masih bayi atau Balita kiranya relevan akan informasi ini, khusunya yang sedang tinggal di Jepang. Apa di Indonesia juga sudah ada kasus yang terjadi, ya? Semoga belum, agar tidak menambah pusing urusan kesehatan di Indonesia. Boro-boro mikirin “Si Kawasaki” ini, urusan Demam Berdarah tiap tahun aja sudah bikin “pusiiiing deh …” (baca: sambil nempelin telapak tangan di jidat, ala Si Tukul).

Insya Allah ini baik juga bagi para “Bapak/Ibu baru” untuk menyimaknya, barangkali dalam waktu dekat sudah pingin “akachan wo tsukurimasu” (translate: momongan baru)…Ok, silakan disimak, moga manfaat …(sumber informasi: The Japan Kawasaki Disease Research Commitee, Japan Red Cross Medical Center).

Juga bisa disimak di sini: http://www.ppi-osaka-nara.japati.net/cgi-bin/jepang.cgi?bacaarsip&1204125765

 

Diagnostic Guidelines of
Kawasaki Disease

(MCLS : Infantile Acute Febrile Mucocutaneous Lymph Node Syndrome)
(The 5th Revised Edition, February 2002)

This is a disease of unknown etiology affecting most frequently infants and young children under 5 years of age. The symptoms can be classified into two categories, principal symptoms and other significant symptoms or findings.

A. PRINCIPAL SYMPTOMS

  1. Fever persisting 5 days or more (inclusive of those cases in whom the fever has subsided before the 5th day in response to therapy)
  2. Bilateral conjunctival congestion
  3. Changes of lips and oral cavity: Reddening of lips, Strawberry tongue, Diffuse injection of oral and pharyngeal mucosa
  4. Polymorphous exanthema
  5. Changes of peripheral extremities:
    {Initial stage}: Reddening of palms and soles, Indurative edema
    {Convalescent stage}: Membranous desquamation from fingertips
  6. Acute nonpurulent cervical lymphadenopathy

At least five items of 1-6 should be satisfied for diagnosis of Kawasaki disease. However, patients with four items of the principal symptoms can be diagnosed as Kawasaki disease when coronary aneurysm or dilatation is recognized by two–dimensional echocardiography or coronary angiography.

B. OTHER SIGNIFICANT SYMPTOMS OR FINDINGS

The following symptoms and findings should be considered in the clinical evaluation of suspected patients.

  1. Cardiovascular: Auscultation (heart murmur, gallop rhythm, distant heart sounds), ECG changes (prolonged PR/QT intervals, abnormal Q wave, low-voltage QRS complexes, ST-T changes, arrhythmias), Chest X-ray findings (cardiomegaly), 2-D echo findings (pericardial effusion, coronary aneurysms), Aneurysm of peripheral arteries other than coronary (axillary etc.), Angina pectoris or Myocardial infarction
  2. GI tract: Diarrhea, Vomiting, Abdominal pain, Hydrops of gall bladder, Paralytic ileus, Mild jaundice, Slight increase of serum transaminase
  3. Blood: Leukocytosis with shift to the left, Thrombocytosis, Increased ESR, Positive CRP, Hypoalbuminemia, Increased α2-globulin, Slight decrease in erythrocyte and hemoglobin levels
  4. Urine: Proteinuria, Increase of leukocytes in urine sediment
  5. Skin: Redness and crust at the site of BCG inoculation, Small pustules, Transverse furrows of the finger nails
  6. Respiratory: Cough, Rhinorrhea, Abnormal shadow on chest X-ray
  7. Joint: Pain, Swelling
  8. Neurological: CSF pleocytosis, Convulsion, Unconsciousness, Facial palsy, Paralysis of the extremities


REMARKS:

  1. For item 5 under principal symptoms, the convalescent stage is considered important.
  2. Non-purulent cervical lymphadenopathy is less frequently encountered (approximately 65%) than other principal symptoms during the acute phase.
  3. Male : Female ratio : 1.3-1.5 : 1, patients under 5 years of age : 80-85%, fatality rate : 0.1%
  4. Recurrence rate : 2-3%, proportion of siblings cases : 1-2%
  5. Approximately 10 percent of the total cases do not fulfill five of the six principal symptoms, in which other diseases can be excluded and Kawasaki disease is suspected. In some of these patients coronary artery aneurysms (including so-called coronary artery ectasia) have been confirmed.

The Japan Kawasaki Disease Research Committee, c/o Department of Pediatrics, Japan Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan
Phone : +81-3-3400-1311, fax : +81-3-3400-1394

Website: http://www.kawasaki-disease.org/index_e.html

The Committee deeply appreciates Professor Masato Takahashi of Childrens Hospital Los Angeles for his advice in translation of these Guidelines into English.

 

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4 Responses to “Lebih akrab dengan Penyakit KAWASAKI …”

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