Anda di halaman 1dari 6

Tinjauan Pustaka

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
 
2
34"&
56
 
!

 $##
 $
  



 
7

 



&84&)



#   
 
 


# 
9 $

$ 
#
  
 

#  
 #

jangka panjang terhadap gejala sisa koroner. Tatalaksana sindrom Kawasaki adalah Intra Venous
 

2 : *6

 "


 
  
  
-

# 
: *

   
 
 
!
5  
#"
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
5 
5> 



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.

Korespondensi: Keywords:   
 

  


 

    
  
 !" #$
%
$

  &'


72
@
   
C
D
E $ Sindrom Kawasaki

PENDAHULUAN pada Simposium Sindrom Kawasaki Internasional ke-8 di


*
   
+* ,   -. 



  * @
=<<5     *     

       
 
     
 /  - 


9 
  -  ? H -* 

     

    
 - 
  
- M@0 
   0 B =<<A-
 N.  
   0  
 

0 
0
.   
& =<4)  
 
; 
 
= -   

 
   
  

0 
  1   

     
 -9      * 

0 
& 
  !#$
  " eritema pada telapak  
9 
  -   
   
+   

      
                
 H  M 
H*M@0 
   
 
,
     
  
      
&
  

&   
 .
   
&  +
   34 ETIOLOGI DAN PATOGENESIS
,1-4 %

*  0  9
    0 
9   

*    -!;

atau - *    

 
 
. 

 
mucocutaneous lymph node syndrome 
 
 
    
    *     
  -  
*    -    
 0  
       ;    
 
& 
   -         

 
 
   
        4<- 
     0         
 
&
 

      

 
   
           &    *   0 
  
   0 -
=<;=>1-4 sel @8     O@P   
! &   
*  
 

  
   

     
. 
   
. 
 9
     

- 

     
?
;? 
  
  *       
  

  
+Q,;4
 
        -  
      0    tumor necrosis factor +N",;RQ;E   
 
   
 
-


       vascular endothelial growth factor     


  
*
   
 
- 
       
   
   9    + # 
  

 
); 4AA<,      
      Q;=+Q;
@

 *  
   


  =H, * Q;=H
   
   

 0 
 * 
  A<>  
  
&  
 

          0 
    
 
   
  
  
   
         
       
 
 0    
.   
   - 

* 
-  B -   
 
   

   &    *  
-  
 -      
   

* *    
 
 



 -  

 

     
 
  
0 
     ;   .      
 ;
 

    @

 
 . 



     Q;4N";R  
 & +N",;T4EA
   -

   
 * 1,4,6,7 Q     *   0      


  

 
& 
  .
%
;9 
EPIDEMIOLOGI $5 
   "
 
5 
B, dan human
*     
        
   
  - adenovirus
  
      

  
 
 
   
?
      

  *    

   
  
  - 


  

      
E;4=  *    
  

 
 
4) 
*     
  
 4( ; =<F   4<<<<<   
 /  - Staphylococcus aureus pada 11 pasien dan streptokokus
  

  


G 

 ?
 
1H 
   = 
4EA4<
 
; 
$      -4$4<
  - * 
 
 444  4<<<<<  
/ -* 0  GEJALA KLINIS
   0 
  
  0 *   -

 
1 

 Gejala umum

- 
E<     

  -  



0 
* 

 0 

 &  $  
   ;   ?

 

     
&
 .   "    0 
  (;4- 
   
 
  -
   - =<<<   
 EA    
    
    
 4<);4<U"   
4<<<<<  
/ -%
 

* 

 
  4;= 
 -      -
  );
  4AEE =<<= 
 4E 4<<<<<   


 
 
 
    
 
 
    
  1,2,6-8
0
.    -  & 
  

      
Insidens SK per tahun di Indonesia diperkirakan
      
"   
- 
 ;= 
  <<<   
0 -   


     -@   
  0 
    

   
 4<<    - * 
       

      &  

"  .     
 
  

  =( 
*   -
  

()
: : 
JL
M
N
@
N(4QR
UN
8
UU

  
-
 (<- 
    
    
  &   H  
   *   

  

 
W  
  
 1,2,11   
  -

     
  0  
  
   -     
 
 
 
Manifestasi nonmukokutan 
 
 
  - %


   F<;A<>
 
   -     
Q 



&


         
0 
0
. 
   0 
  &   -
 &  .   %

   
  .

  

W  
 . 
   0 
  - 
     
  &  

 
  

   
 .
      
 

  - 
 ;(1,6,11
 
   
.  ?   
 
   
0   0 
           
&  

 
    
  -  1,11 Deskuamasi periungual
9  
 0   
   

    
 @   
  
     0 
;0 
     
  
    

  
 


*    
 
-   &   
  4-
 )
  
 
 

  
 &    
   
   -  
 Q 


 

   
  
 ;=  ;) -  
 
      
          
@   
  
 
    

   -
       -
           
  


E> 
X     & +
&
 
 

   @   
  
  
  
   
&
,     )<> 
            



    
   &  
 
0 
-    * 2,4,6  1,6
      0   - 
 .
 
   
      
   <> 
Q
&   
 Edema dan eritema tangan dan kaki
   0 

   
       0  %    
     0 
   -  
  - 
     
  
   
    
  -           
  
   
    
  

    

 
   
 
   
%
         
  -
  
  
&X   

*  
 -  
  -
             
 %

  -& 


  
&0
.

  
&+   
 
 
                
 
 

> * , 

  
 +. 
  
   
 
&          
,. 
     
  
&
    
  
    
      
 -   

&   
   
  =)E44  
   

  -
 
      
   -     

     

Gejala mukokutan 

 
 

  
    &    
6,11
Erupsi polimorfik, dermatitis skarlatiniformis pada     0      F<;A<> 

  -

  
                
  
  -   
0 
0
.   Kelainan mukosa orofaring

&   
 .
     0  

  
    & 
 *       ;
  
  *   -   
         
  1   

 
  
 
&  


&
   - 

  -   

      & 

      . 
 
 95 
H 8* 
W  
  
&     !#$

    
&  
 
4,6 tongue  -   

   0 
  
F<;A<> 6,11
Erupsi kulit
     
  
 
 
 Kelainan kuku
eritematosa polimorfik, erupsi difus makular, 
   
 


   

skarlatiniformis, $
 -8  +  
, *    -         
      (>
 

&
     ?    
               
-
 
       
   %  
 
 @

 
  0 
      .       -
  F

     

 0  
   - 
   -
   Q 


 
   
  - 
 
    - 
   . 
       
  

        

%

  
          
      

 
 
-   
 
    
 
- 
      
 
            -           -    
 
  

 
          1,6

74
@
   
C
D
E $ Sindrom Kawasaki

9 ;
          

     -+/)!Q,
       - & 
 
  0       
 ? 

 0 
   
   
     
 .     0 
  &  .   *  

       
  -
 
 *  
 
4 
=     -      0 
   menunjukkan temuan spesifik, terdapat edema papila

 -
   -     B
  
   -
   
     
     
    &   
  
 -  
  

   
       

   
.       
 
 -     -     
  
  -   

 

  
  -  - 
4)
     -     - 
        -    
 1+% X, 0 
  
 -   
        
 -  
 
 
- 
   - 
*   &   X   
 --


0 
     
    % X     
 .  H     0 
           
 @ &
      -
 1. 
 

  \  



0 
           .      
 . 
    -   *; 
1
 
   0  


 0   0 
  % 
 &
 =;
 
 
     


  -    4,6,12 &
. 
   
  
 
  
   &
  
 
 American Heart Association
Kelainan kutan yang jarang +?G?,    
   
   
 &

          

 *     
  ;
? 

    = * X   
& 
=  ;E    ;F     
 *     
 


     

 4= 
      
 Pemeriksaan Magnetic Resonance Imaging (MRI) dan
  
    
      ZX          
       

  
  
       
 -

 [X  +
 4AA),     
 *  ?
 &
     
- 
     *    
 
)( -    
  
            
           
  
&           
     1,14,15 Kelainan koroner
    

 
     
         
    FE>   +E  
 (  ,    * 
  
  -@
    
    
   F>          
W    
  

   &
  *  
   


  +
 )       


 dan cardiac ultrasound scanning15

  0     
   

 
      
&   
  .
    
&   

DIAGNOSIS


 
     4;=E444)
@

 *  
       
 
?G?  

0      4@

*  

  
 
PEMERIKSAAN LABORATORIUM
0
       
   
      -  
   
    
    &    *  
 
  
  
 
1

   

 1     
 
? 
 

     - 

   Tabel 1. Kriteria diagnostik sindrom Kawasaki
 

        
          
 
  
&  
    

 @  
 - 
  
-   0    
    -

      - *    
    

    

 
 
 
$
  
 
    -  
   
   1 0 
0
.   
&  
    
  

<<<<< -
  4<<<<<<!)    &       2 *  
  - & 
 
$
0 
  1   



   
    
  -    =;)
0 
& 
    
) *  
     -   
  
$ 
    
 

  
 
 
    
&&            
            
  
 


1,4    
 
 


  
 
  

 
      - 
 4 %   
1
(> 
  
     
H  &   5 Q
&   
 .
  
& +
  34,

  H85
  R4; 

 
 
       
     -
  SK incomplete
   
  
    
E;4< 
 Q 0   

 0   
     

   - 
     -
  
     
 

&   *          --
  *     
  
    0         

 -
   
             *  incomplete 
    
*       
 .
    
     3- 
  
  
  
 
  

75
: : 
JL
M
N
@
N(4QR
UN
8
UU




 
* 0
    
    
  
  8  5
$ $
$  
 

  
 1,14      
= -      
ZX
  

  
* 4=4A
DIAGNOSIS BANDING    
 
      * 
@

 
 *    - scarlet fever,  
-. 
 
 
   
  
Staphylococcal Scalded Skin Syndrome (SSSS), infeksi 

 
   
    
    
.
+


& 
  .
,%
  M
&            
     
  
+%M,   
 * . ;- +**, !#$
      0  &  
 
  
tongue    
  & .    
  
&    *       - 
   ;  

 

   
    0     !#$
   0        
 
 
    *    
 

 0 
  * + 
 <> ,     -     

  


  
   
 
  

  
** %M   **    


      & 
.
   

 

%M 
- 
& X    ****  0    ZX  

-



   
    
        
& 
  .
 ZX    -  
     
  -
   0
.

       ZX  
- 
 
   
  

    

  - 
 4)44 *   4)F4E4F

PENATALAKSANAAN KOMPLIKASI
G     
           
 *    . 


 
  
 
  
   -   -     
    -   
    
 -
            -

 
  


@  


   
*     

 
 
  
 
 
& 0   0 

4<- 
   
-    
 
0  -
  

-  4  
    * 
% 
           
    
 
    0 
   
& Q 
  
  0 
  
0    
G   
     
 ;4>  
       0  0 
  
  
        - 
   
 *       -  
*        
0 
  
 
 
 
 
1,6     ;  9   
 

  
 
    -      0    0   -  
Penatalaksanaan topikal     7,20

        
 -   
&  
 Q 
 .      * 

      
     *    
   

  
&    
       
   
  

 

   
   

1,6  
&
 
    
 @      0 
 
     
    0   

  
   
&   

 
  1 

Penatalaksanaan sistemik
difus atau parut fokal pada daerah iskemia miokardial atau
         
 
* # 
& 9
&G+? =<4),   - 


+ZX,


  

   - 
W  
   
& 
  *   =<<-
 @   
    
  0 
   
   
   
 =<4= -  A  
? 
   
 * 4(
    
 ZX 
   = ! 

&
@
    
 
 0     =)  
 
 =4
   4<;4= 0  
       4< - 
  0 
 
  
  
   
 4 
  

   
* 
 4<>   
  
  
 
 
 
    4  
    &
  
 

ZX    
              
X g;M  %  +M    =<44,    
  
ZX   
   
4!  
  *      
; 
 
    


           
   


 
   
&  . 

  
20
ZX      
   
  -
 &  
 -     -  
  
 12,16-18
?

          
  
 PROGNOSIS
  
    


 &  

W  
 

 
 @

 

        
   
  
   ?



   
  F<;4<<       
 *    
 ZX    4
! - 


  
   4- 
    
    - 

       -  0 
 
 
  
-  );!    E;F  
   
            


   
+=<<F,         
    
  -  
  

 

76
@
   
C
D
E $ Sindrom Kawasaki

  
     4<- 
  
-

 
  DAFTAR PUSTAKA
 
  
      ZX   4 Q  @qM M
  GO Q?[ Kawasaki syndrome. Dalam:


     
       


  
- "  M%
 ?x[&&? ?  "X
-Q? g*
 

 $

 
5 %

 ;(N q$

   
 0
    
W  
 
- 
  MX ;G
y=<<F-4E=E;))
  
  
         0 
 = * M9" N    [ Kawasaki disease @  $ 
  HM
     
 
.  
- 
   
 *  9M@ X   * *- N 9 -  H%  
 Nelson
=#
-
5
`
84'-
  -
$*  y=<44-FE=;(
       
    0 
 
  )  [Q   
  9 O !
 @  $ .
 
 
 
-      
   

 ?@ G  Gq ?O  
 \;
=#
-
5

infark miokardium, sudden death      0   $


`
8LG$[
 ;9  y=<44-4EF4;4<
   ?*M 

?Vasculitis disorders@  $  ?*M 

?
 
&
 
*     
    
\ !B
5  5
5
 $
`
8J9
0
$
    
  
 
  

 % .
y=<44$EA4;E
0   0 )=4  ?. 
 N !;
b
= 5

  @  $ "

?
; 
1 

O 
 O 
* y=<<Ey9 
   O%  +=<4=,     - 
   

 -
 y=<<E
  
 \ 8 
]  $
^-
7- +GH\BQ, E * - 
9  ** ?*  Kawasaki disease Capsule
 -   =F<   *      -     Summary.?? @  =<4)yEA$<4 4; 44
           
  -
  
&   ( G *; Q
M;O- G;OG *;O[M;GEpidemiology of
!
b
  5
-
 
#
 
-  
 

   
    
*      
 5
#$
$
$ 5
   
=<4)y4E)$4=E;)4
      
     -
 GH\BQ  
22 F *
 
H   

   
O
N?=<4=yA$=z

  %**  +=<4),     - 
   

 A q MQ @qM*-
. MEvidence for the involvement
-
#5
   

"
5
"
 
!

  
-    
   
   -   syndrome"%M*M

Q  =<<<y4A=$4;(
.  
 
*     
     4<9  *M ." -? G
 
MB*  -OX


%G
 

    

   -  .    # 
    8N
5

5 
!
!
$ 

=) Arthritis and rheumatism.4AA<y))$4)(4;E


  M 
  
* 
 
  
 44% N9[ @[Kawasaki syndrome?  @  
 
    
   
  

   
 4AA<y)4$E4;(4
 
 
 
     -        0   4=M 

?*- 
;?
?Other viral diseases@  $9
Q

gg Q H 

 H  
 @   %

  ;= *
$
 0  @          -
   0    *  M ;% .
y=<<F
   
  0 - 
   

    4)-

[XM  HAdult Kawasaki syndrome.9@  4AA)y
    -@  

0     4=A$))<;)
=4=) 4G 
@ "G ZX ""  OZ
 Increased
    
        
   detection rate of Kawasaki disease using new diagnostic algorithm,
including early use of echocardiography 
=<<Ay4$EA;AA 4
SIMPULAN 4 
 Q Q 
 ? X
 O   ;? Q   Z {;  
H
 $
-
5 
 
 5 
!


&'

*    . 





      pediatric patients
9 *
 =<<Ay(E$F4;
  
 
     
       0 4E   -
* 0
B 
  -
 N   ?   G
`-+55$
-
  # 
 
   
-
 
-
5 $

-
      
  *    
  
   
 $
#  


!

 `
 $6b


tahun ke tahun, namun kasus SK di Indonesia masih  "


 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
.    X    

 *   

    0   = 5
5
-
H5 
=<4)y4<E$((;F
       -
  
-  4F9  * Kawasaki disease: etiology, pathogenesis, and treatment
   
      



*  O .  O
M 

 =<<=yEA$EA;(F
4A   
  "0
 ?   -
 * M * * q  8  5

@

 *  
        
 
 ?G? $ $
$ b
 
5
!
  
 
$5

@

 
 *   
        

 $
2`6
$ 
  5
#$

 
-
!

  . 

  0     



   disease.?? @  =<<AyE<$4E;A


      *   
  =<X g;M %O  |?ZO  -  ?*O ;%-
 
Z!

5 5
#$
5   
5 
 


   0   


  0 
 gangrene?? @  =<44yE$ (; 
 
 1   
 1 - 
  
  =4X9 -?M9OWhen children with Kawasaki disease
  
   

 

 1 grow up: myocardial and vascular complications in adulthood?O
O 
=<<Ay$4A44;=<
   
      
 

  ==   O% G .   Q 9  9M H M?. 
  M
  
  *    -ZX  


*  X -
 M?  ]  $
-
7-
 
9
 5  


   
 0
     
   
   
 5
H 
!

\$
-
!
 
=<4=y
4E4$)4;A 4
 0
   
ZX


- 
4<- 
 0    2)
 %**X @X .  9  ?Q . *BN
*H
  
 Vascular health in Kawasaki disease?O  O 
=<4)yE=$444;=4

77

Anda mungkin juga menyukai