1. Reminder: Class Housestaff tomorrow 1 st -2C, 2 nd - 2031, 3 rd - 3302 Board review take-home quiz due 8am Monday You may email your answers or place them in our box Compliance due by 8am Monday Log clinics and have PREP questions completed for August Sept Board Review is 15 days away… study your endocrine!

3.  Generalized vasculitis  Preferential to coronary arteries  Genetic predisposition  Possible infectious trigger  Highest incidence in Asians, especially Japanese  Median age 2y/o  75% < 5y/o

9.  Least common feature  Unilateral, anterior cervical triangle, >=1.5cm  Firm, nontender, no overlying erythema

10.  Fever is high spiking and remitting  Polyarthritis/arthralgia  Occurs within first week  GI complaints  Hydrops of gallbladder  Hepatomegaly and jaundice  Aseptic meningitis in 50%

13.  IVIG 2g/kg  Aspirin  High dose (100mg/kg/d) at least 14 days  Low dose (5mg/kg/d) ▪ May discontinue at 6 to 8 wks if normal coronaries  Give influenza vaccine  Defer measles and varicella vaccine for 11mos after IVIG

14.  Age < 6mos  Fever lasting 7 days  Elevated acute phase reactants  Get echo even in absence of other signs

15.  10% fail to respond to initial IVIG  Fever after 36hrs  Re-administer IVIG  IVIG refractory Kawasaki Disease  Persistent fevers or elevated inflammatory markers despite 2 courses of IVIG

16.  Virtually all deaths are cardiac  Peak mortality at 2 to 6 weeks  Myocardial Infarction may occur years later

17.  Coronary artery aneurysms in 25% if untreated  50% Resolution of aneurysms 1 to 2 years after disease onset  Echocardiography at diagnosis, 2 and 6 wks  Treatment and activity individualized according to risk level