Discovered by Japanese scholar Tomisaku Kawasaki in January 1967. It is more prevalent in Asians, especially in Japan. Examples: Japan (2010): 239.6/10w, Shanghai (2003-2007): 36.8-53.3/10w, U.S. (2009): 19/10w. The peak incidence is from June to November, with an incidence rate of 77% within 2 years of age and rare within 3 months and after 9 years of age. It can occur in all seasons, but is slightly more common in China in the spring and summer months. Differential diagnosis Scarlet fever: non-polymorphic rash, no conjunctival congestion, peeling all over the body, rare within 3 years of age, lack of typical coronary artery damage on echocardiography, positive pharyngeal swab culture for group A streptococci, sensitive to penicillin or B-lactam agents. Exudative polymorphic erythema: there are more than two mucosal lesions, there is purulent conjunctivitis, and the rash may be herpetic and ulcerative. Juvenile rheumatoid arthritis: The disease may also present with fever, rash, superficial lymph node enlargement, and elevated peripheral blood WBC, but the disease has a long duration and is often not accompanied by prune tongue, chapped lips, hard edema of the palms and soles, erythema, and skin peeling, etc. Echocardiography generally does not show typical signs of coronary artery injury, and its serum rheumatoid factor may be positive. EBV infection: EBV infection may also present with fever, superficial lymph node enlargement, rash, and coronary artery lesions on ultrasound, but the disease is not associated with prune tongue, chapped lips, hard edema, erythema, and skin peeling on the palms and soles of the feet, etc. Serum EBV IgM antibody is often positive. Yersinia pestis infection: Although the disease may present with fever and coronary artery lesions on ultrasound, it is often accompanied by gastrointestinal symptoms such as diarrhea, and in severe cases, renal failure, and pathogenic tests may be positive. Measles: Patients often have a history of epidemiologic exposure, significant khat symptoms, oral mucosa showing measles mucosal patches without poppy tongue and hard edema of the palms and soles, normal or decreased peripheral blood WBC, and elevated serum measles virus IgM. Treatment Aspirin: combined with IVIG at a dose of 30-50mg/kg.d, textbook shows a gradual reduction to 3-5mg/kg.d 2 weeks after the fever subsides, some data show that the dose is changed to 3-5mg/kg.d 48-72h after the fever subsides and is given orally for 6-8 weeks. IVIG:Single dose of IVIG 2g/kg.d combined with aspirin within 10d is the standard therapy for KD; however, IVIG is still available after 10d if the fever has not subsided, coronary aneurysm formation, and sedimentation or CRP is still high at the time of the visit; premature use (within 5d) may require another IVIG infusion. Single-dose 1g/kg.d therapy is controversial, and 400mg/kg.d is completely abandoned. Pansentin (dipyridamole): 3-5mg/kg.d Antiplatelet therapy for patients with elevated platelets. Glucocorticoids are not used as routine treatment. Diagnosis and treatment of IVIG non-responsive KD: If fever does not subside 36h after IVIG treatment or symptoms recur 2-7d after administration (fever and at least one KD symptom), IVIG non-responsive KD can be diagnosed except for secondary infection. kg.d, 30mg/kd.d if ineffective, large doses may significantly aggravate the hypercoagulable state, and those with coronary artery lesions are especially prone to thrombosis, and the highest dose of small intravenous preparations or oral prednisone is used for CAA. 1, no coronary artery aneurysm: within 1 month of the onset of the acute phase of echocardiography is not seen in the coronary artery dilated lesions; only coronary artery wall echogenic enhancement is not meaningful; acute phase of the symptoms delayed more than 2 weeks to wait for the acute phase of symptoms disappeared 2 weeks after the echocardiographic examination as the basis. Treatment: After the acute symptoms disappeared, aspirin maintenance dose of 3-5mg/(Kg.d) was applied until 3 months. Follow-up: Follow-up review once a year at 1 month, 2 months, 3 months, 6 months, 1 year and 5 years after onset, respectively, including cardiac ultrasound, electrocardiogram, platelets, and blood sedimentation if necessary. Exercise restriction: Not necessary. 2. Transient coronary dilatation Those who have had coronary dilatation within 1 month of lesion onset and have returned to normal at 1 month. Treatment: Same as those without coronary artery dilatation, aspirin maintenance dose applied until 3 months. Follow-up: Follow-up review at 1 month, 2 months, 3 months, 6 months, 1 year and once a year for 5 years after onset, including cardiac ultrasound, electrocardiogram and platelets. Exercise restriction: not necessary. 3.Mild coronary artery dilatation Limited dilatation of coronary artery with an internal diameter of 4 mm or less within 1 month of onset; less than 1.5 times the peripheral coronary artery internal diameter in older children over 5 years of age. Treatment: Aspirin maintenance therapy is recommended until 3 months after normalization of the coronary lesion. Follow-up: Echocardiography was performed at appropriate intervals during the acute phase, and conventional cardiac ultrasound with drug-loaded echocardiography and electrocardiogram was repeated once a year at 1 month, 2 months, 3 months, 6 months, 1 year, and 5 years after onset. Exercise stress ECG is recommended. If cardiac stress test suggests myocardial ischemia, selective coronary angiography may be performed within 1 year of onset if necessary. Strong physical activity should be appropriately limited during the follow-up period, but generally within 8 weeks of disease onset. 4.Moderate size coronary artery aneurysm The internal diameter of coronary artery aneurysm is 4-8 mm within 1 month of disease onset; 1.5 to 4 times the internal diameter of the peripheral coronary artery in older children over 5 years of age. Treatment: Continuous antithrombotic therapy is recommended. Follow-up: Echocardiography is performed at appropriate intervals during the acute phase, and routine cardiac ultrasound with drug-loaded echocardiography and routine and exercise stress ECG are repeated at 1 month, 2 months, 3 months, 6 months, 1 year, and every 6 months for 5 years after onset. Such patients need to continue taking aspirin and antiplatelet drugs if the coronary aneurysm does not subside; the duration of restriction of strong physical activity is prohibited according to the exercise load ECG. 5. Huge coronary aneurysm The internal diameter of the coronary aneurysm exceeds 8 mm within 1 month of onset, and is greater than 4 times the internal diameter of the peripheral coronary artery in older children over 5 years of age. Treatment: From the time of thrombosis in the aneurysm to the 3-month risk period when myocardial infarction is most likely to occur, continuous antithrombotic therapy must be given and closely monitored. Surgical or interventional treatment is necessary. Follow-up: Echocardiography for the presence of intra-aneurysmal thrombus and electrocardiography for myocardial ischemia are necessary in the acute and risk phases. Selective coronary angiography can be performed at six months to one year follow-up based on clinical symptoms, ECG, echocardiography, and myocardial perfusion isotope examination suggesting ischemic signs. In the absence of coronary infarction, long-term anticoagulation therapy with aspirin and warfarin is followed up once a month during drug therapy after discharge, which can be changed to once every 3 months after the condition is stabilized. Such patients also need to have annual follow-up chest X-ray and exercise stress ECG, restrict daily activities and prohibit any sports.