LAUSR

Kawasaki disease (KD), a systemic vasculitis, is the leading cause of acquired heart disease in industrialised countries. Despite decades of research, the aetiology and pathogenesis remain unclear. Prompt diagnosis and management of KD are essential to reduce the risk of coronary artery damage that may cause significant morbidity, including risk of myocardial ischaemia or infarction, and occasional mortality. In practice, this is often difficult due to a lack of a diagnostic test and relies on the recognition of a constellation of clinical features. Since the American Heart Association (AHA) guideline in 2004,1 there have been over 2000 scientific and clinical publications on KD. The recently published 2017 AHA guideline, a scientific statement, provides detailed updated recommendations on the diagnosis, management and treatment of KD.2 Here we highlight and summarise the key updates of particular relevance to paediatricians and discuss other recent advances. ### Diagnosis Box 1 ### Diagnostic clinical criteria for classical Kawasaki disease Presence of fever for at least 5* days with at least four of the five following clinical features: 1. Erythema and cracking of lips, strawberry tongue and/or erythema of oral and pharyngeal mucosa. 2. Bilateral bulbar conjunctival injection without exudate. 3. Rash: maculopapular, diffuse erythroderma, or erythema multiforme-like. 4. Erythema and oedema of the hands and feet in acute phase and/or periungual desquamation …