Guidelines for diagnosis and treatment of Kawasaki disease by general practitioners (practical edition in 2025)

doi:10.3969/j.issn.1004-583X.2025.10.001

Abstract

Abstract:

Kawasaki disease (KD) is an acute self-limiting inflammatory disorder that mainly affects small and medium-sized blood vessels throughout the body. It is more common in infants under 5 years old. The pathogenesis of KD remains unclear, and its clinical manifestations are diverse. KD can be divided into the complete and incomplete types, and the diagnosis of the latter type is more challenging. This guideline, based on the latest evidence and practice, systematically expounded the epidemiological characteristics, diagnostic criteria, treatment principles, referral recommendations and diseases management of KD, aiming to standardize primary medical treatment behaviors, improve the prognosis of children, and reduce the risk of coronary artery complications.

Key words: Kawasaki disease, diagnosis, intravenous immunoglobulin, coronary artery disease, treatment, follow-up

CLC Number:

R543

Kawasaki Disease Diagnosis and Treatment Center of Shaanxi Province/ Children's Hospital of Shaanxi Provincial People's Hospital, National Clinical Research Center for Child Health and Disorders/ Children's Hospital of Chongqing Medical University, National Children's Medical Center/ Beijing Children's Hospital, Capital Medical University,Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, National Regional Medical Center/ Shengjing Hospital of China Medical University, the Committee for the Compilation of Primary Guidelines for the Diagnosis and Treatment of Kawasaki Disease, Initiative Medicine Committee, World Artificial Consciousness Association. Guidelines for diagnosis and treatment of Kawasaki disease by general practitioners (practical edition in 2025)[J]. Clinical Focus, 2025, 40(10): 869-873.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2025.10.001

https://www.lchc.cn/EN/Y2025/V40/I10/869

Figures/Tables 2

References 11

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管理阶段	核心目标	主要措施	责任人员
一级预防	病因预防	目前尚无特异性的有效方法。	-
二级预防	通过早诊断、早治疗,预防CAL的发生。	早期识别与转诊:提高基层对KD的识别能力;掌握并及时执行转诊指征。规范初始治疗:在窗口期内(发病10 d内)规范使用IVIG和ASA。启动系统随访:对所有确诊患儿建立随访档案,启动急性期后随访。	基层医生、专科医生
三级预防	对已发生CAL等并发症的患儿进行管理,改善生活质量和长期预后。	药物治疗:根据CAL严重程度,长期应用抗血小板(如ASA、氯吡格雷)或抗凝药物(如华法林)。生活方式干预:依据CAL分级,对体育活动进行个体化限制与指导。专科监测与干预:定期进行心脏影像学(超声、CT等)和功能评估;对心肌缺血、心功能不全进行药物管理;对严重CAL行介入或外科手术。	儿童心脏专科医生

管理阶段	核心目标	主要措施	责任人员
一级预防	病因预防	目前尚无特异性的有效方法。	-
二级预防	通过早诊断、早治疗,预防CAL的发生。	早期识别与转诊:提高基层对KD的识别能力;掌握并及时执行转诊指征。规范初始治疗:在窗口期内(发病10 d内)规范使用IVIG和ASA。启动系统随访:对所有确诊患儿建立随访档案,启动急性期后随访。	基层医生、专科医生
三级预防	对已发生CAL等并发症的患儿进行管理,改善生活质量和长期预后。	药物治疗:根据CAL严重程度,长期应用抗血小板(如ASA、氯吡格雷)或抗凝药物(如华法林)。生活方式干预:依据CAL分级,对体育活动进行个体化限制与指导。专科监测与干预:定期进行心脏影像学(超声、CT等)和功能评估;对心肌缺血、心功能不全进行药物管理;对严重CAL行介入或外科手术。	儿童心脏专科医生

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