SUMMARYWe serially monitored cell surface antigen expression on mononuclear cells in peripheral blood isolated from patients with Kawasaki disease (KD), and found, for the first time, that a markedly increased number of CD4 þ CD8 þ T lymphocytes was present in some of the patients (11 of the 24 cases). The cases of five of these 11 patients were complicated with coronary artery lesion (CAL); the 13 patients with normal numbers of CD4 þ CD8 þ T lymphocytes did not have CAL. The patients' age, sex and grade of systemic inflammation evaluated by peripheral leucocyte count and serum C-reactive protein levels were not correlated to the number of CD4 þ CD8 þ T lymphocytes. Other cell surface antigen characteristics of the CD4 þ CD8 þ T lymphocytes included CD3 þ , CD45RA þ , CD45RO þ , CD16 ¹ , and HLA-DR þ . These results indicate that the surface antigen characteristics of the KD peripheral blood examined were the same as those of Epstein-Barr virus infection without CD45RA þ . These findings provide useful information for the analysis of the pathogenesis of KD.