分析1例川崎病并发胆汁淤积和无菌性脑膜炎患者的临床特征，以提升临床对川崎病少见并发症的关注度。

回顾性分析2021年8月9日西安市儿童医院收治的1例川崎病合并胆汁淤积及无菌性脑膜炎患儿的临床资料、诊疗经过和预后。

患儿入院后血细胞分析提示白细胞（25.12 × 10⁹/L）升高，中性粒细胞比率为85.6%，C-反应蛋白（CRP）：159 mg/L，红细胞沉降率为77 mm/h，肝功能：总胆红素（150.3 μmol/L）和直接胆红素（117.4 μmol/L）水平显著升高，丙氨酸氨基转移酶（78 IU/L）和天门冬氨酸氨基转移酶（68 IU/L）水平轻微升高，总胆汁酸（143 μmol/L）水平升高。腹部CT显示胆囊体积显著增加，胆管无明显扩张。超声心动图显示双侧冠状动脉扩张。脑脊液检查发现其压力轻度升高，脑脊液细胞学、糖及氯化物均正常。脑部磁共振成像（MRI）和脑电图均正常。患儿诊断为川崎病合并胆汁淤积及无菌性脑膜炎，经静脉滴注丙种球蛋白2 g/kg抗炎、阿司匹林和双嘧达莫抗凝、注射用丁二磺酸腺苷蛋氨酸利胆退黄、甘露醇脱水降颅压等治疗后患儿体温正常，黄疸消退，精神正常，各项指标恢复正常，无后遗症。

川崎病同时并发胆汁淤积和无菌性脑膜炎的病例临床较少见，易漏诊误诊而延误治疗。对患有胆汁淤积和（或）无菌性脑膜炎和不明原因发热5 d以上的儿童应警惕川崎病，早期诊断和及时治疗可减少川崎病的并发症。

To analyze a case of Kawasaki disease complicated with cholestasis and aseptic meningitis, and to raise the attention to the rare complications of Kawasaki disease.

The clinical data, diagnosis and treatment process and prognosis of a child with Kawasaki disease complicated with cholestasis and aseptic meningitis admitted to Xi’an Children’s Hospital on August 9th 2021 were analyzed, retrospectively.

After admission, blood cell analysis showed that leukocytes (25.12 × 10⁹/L) increased, neutrophil ratio 85.6%, C-reactive protein (CRP) 159 mg/L, ESR 77 mm/h, total bilirubin (150.3 μmol/L) and direct bilirubin (117.4 μmol/L) increased significantly, alanine aminotransferase (78 IU/L) and aspartate aminotransferase (68 IU/L) increased slightly, total bile acids (143 μmol/L) increased. Abdominal CT showed a significant increase in the volume of gallbladder and no significant expansion of bile duct. Echocardiography showed bilateral coronary artery dilatation. Cerebrospinal fluid examination showed that the pressure increased slightly, and cerebrospinal fluid cytology, sugar and chloride were normal. Brain magnetic resonance imaging (MRI) and electroencephalogram (EEG) were normal. The patient was diagnosed as Kawasaki disease with cholestasis and aseptic meningitis. After treatment with intravenous gamma globulin 2 g/kg for anti-inflammation, aspirin and dipyridamole anticoagulation and inhibition of platelet aggregation, ademetionine for promoting jaundice regression, mannitol for cranial pressure reduction, the temperature returned normal, jaundice subsided, and his spirit was normal. After reexamination, all indicators recovered to normal without sequelae.

Kawasaki disease complicated with cholestasis and aseptic meningitis is rare, which is easy to be misdiagnosed and delayed to receive treatment. Therefore, clinicians are reminded to be alert to Kawasaki disease for children with cholestasis and/or aseptic meningitis and unexplained fever for longer than 5 days. Early diagnosis and timely treatment can reduce the complications of Kawasaki disease.