How to treat pediatric Kawasaki disease

  Kawasaki disease (Kawasakidisease, KD), also known as mucocutaneouslymphnodesyndrome (MCLS), is a systemic vascular inflammatory disease with small and medium-sized arteritis as the main pathological changes, mainly manifested by fever, rash, mucocutaneous rash, conjunctival congestion and non-purulent cervical lymph nodes The main manifestations are fever, rash, mucous rash, conjunctival congestion and non-purulent enlargement of cervical lymph nodes. If left untreated, about 20% of children will develop coronary artery injury, which leads to coronary artery dilation and coronary aneurysm formation, the most common cause of acquired heart disease. Kawasaki disease is more common in infants and children, mostly within 5 years of age, and more in boys than girls. Treatment emphasizes timely diagnosis and early treatment, mainly using symptomatic, supportive and anticoagulant therapy.  1, gammaglobulin: best used within 10 days of onset, given as a single dose, intravenously, at a dose of 2g/kg, with 1 or 2 additional doses if there is static C resistance.  2.Aspirin: 30~100mg/kg?d orally, divided into 3~4 times, reduce to 3~5mg/kg?d 3 days after the fever subsides. in the absence of coronary artery damage, the course of treatment is generally 6~8 weeks; if there is coronary artery lesion, it should be taken orally until the coronary artery returns to normal and then stop.  3.Other antiplatelet therapy drugs: such as clopidogrel combined with aspirin, dipyridamole combined with aspirin.  4.Anticoagulant drugs: Indications are those with moderate or above coronary artery dilation, those with rapid coronary artery dilation with thrombus-like echo, and those with a history of myocardial infarction. The drugs taken such as warfarin, low molecular heparin, etc.  5.Glucocorticoid: glucocorticoid can be given when gammaglobulin treatment is ineffective, but it should not be used alone, it can be combined with aspirin and pansentin, and the dose of prednisone is 2mg/kg per day for 2 to 4 weeks.  6.Interventional treatment: Ischemic heart disease occurs in some patients with Kawasaki coronary artery lesions. Non-pharmacological treatment, including percutaneous coronary intervention and coronary artery grafting, is needed for those whose ischemic performance cannot be improved by drug treatment.