关键词: 　川崎病；　静脉用丙种球蛋白；　肺结节；　冠状动脉损害

Abstract: 　Objective　To explore the clinical manifestation, treatment and prognosis of Kawasaki disease (KD) complicated with multiple pulmonary nodules. Methods　The clinical data of intravenous immunoglobulin (IVIG)-resistant KD with multiple pulmonary nodules in a child were reviewed and summarized in combination with relevant literature. Results A 3-month-old boy presented with fever and rash as the main manifestations and had erythematous rashes on the face and trunk, bilateral conjunctival congestion, flush and chapped lips, strawberry-like tongue, redness of BCG-vaccinated site, erythema and edema of the palms and soles. Peripheral blood leukocytes and hypersensitive CRP were increased significantly. Chest CT showed multiple nodular high-density shadows in both lungs. Color Doppler echocardiography showed enhanced echo and less smooth wall of coronary artery. Antibiotic treatment was ineffective. After the patient was treated with IVIG 2 g/kg for the first time, body temperature was normal for 5 days and then fever and congestive rash re-appeared. After receiving IVIG 2 g/kg treatment again, the child was discharged after improvement. At 3 month follow-up, no coronary artery damage was found by color Doppler echocardiography and no pulmonary nodule change was found by chest CT. The retrieved Literature revealed 6 KD patients (4 males and 2 females, age at onset ranging from 4 to 6 months) with multiple pulmonary nodules. All of the patients had coronary artery lesions and failed to respond to antibiotics. One of the patients died of cardiac arrest, and the cardiopulmonary damage of the remaining patients recovered well during the follow-up. Conclusion　A small number of children with KD may be complicated with lung involvement, and multiple pulmonary nodules are extremely rare in KD.

Key words: 　Kawasaki disease;　intravenous immunoglobulin;　pulmonary nodule;　coronary artery lesion