KAWASAKI DISEASE is a systemic vasculitis that mainly affects younger children. Although the definite cause still remains unknown but the clinical and epidemiologic findings discuss an infectious cause. The prevalence of incomplete KAWASAKI DISEASE reported 15 to 36.2%, and it is more frequent in the extremes of the age spectrum. Non delayed treatment of DISEASE should be initiated because of critical cardiac vascular complications. Up to 15%-25% of patients with KAWASAKI DISEASE who remain febrile after administration of first dose of intravenous immunoglobin plus aspirin are classified as refractory DISEASE. These intravenous immunoglobin resistant cases are at increasing risk for coronary artery complications. The strategy on prediction of potentially non responder and treatment of intravenous immunoglobin resistant patients is now controversial but some useful points were recommended.

KAWASAKI DISEASE is believed to be the commonest vasculitis of medium vessels in Asian children. However, the majority of children with KAWASAKI DISEASE continue to remain undiagnosed perhaps because of the lack of awareness amongst pediatricians. The clinical features of KAWASAKI DISEASE can be confused with other common conditions such as Scarlet fever, Stevens Johnson syndrome, Measles fever, systemic onset JIA, etc. Development of coronary artery abnormalities is the hallmark of KAWASAKI DISEASE and accounts for most morbidity and mortality associated with the DISEASE. Quick recognition of the DISEASE and early treatment with intravenous immunoglobulin results in a significant decrease in the occurrence of coronary artery abnormalities.This review emphasizes that KAWASAKI DISEASE should be considered in differential diagnosis of all febrile illnesses in young children.

Objective: KAWASAKI DISEASE (KD) is an intense life-threatening vasculitis. The diagnosis of KAWASAKI DISEASE is made by clinical criteria. This DISEASE is a common rheumatologic DISEASE in Iran. The aim of this study was describe the demographics and clinical features of KD in Iranian patients. Material & Methods: A review was conducted for all cases of KD treated at Pediatric rheumatology department in Children's Medical Center between January 1994 and July 2004. The diagnostic criteria for typical KAWASAKI were based on the criteria of the Japan KAWASAKI DISEASE Research Committee. Atypical or incomplete KD has been described in which patients not strictly meeting the diagnostic criteria but have coronary artery changes. Color doppler echocardiograms were done at the time of diagnosis, 14 to 21 days, 60 days, and 1 year after treatment. Findings: One hundred fifty nine patients were identified. One hundred twenty five children (78.6%) fulfilled criteria for typical KD. Echocardiographic abnormalities were found in 30 cases (18.9%), including 9.6% with typical and 46.1% with atypical KAWASAKI. The incidence of atypical KAWASAKI in our study was about 22%. Coronary arteries aneurysms found in 66.7% and 33.3% was other abnormalities. Male to female ratio was more in patients with cardiac complication (2.3:1).Conclusion: KAWASAKI DISEASE should be considered in any infants or child (especially less than 2 years old) with a prolonged febrile illness. Demographic features of our patients were similar to reports from other country. The incidence of atypical KAWASAKI in our study was about 22%.

Introduction: Pyuria is included in the American Heart Association list of supporting laboratory data for diagnosis of KAWASAKI DISEASE (KD). The aim of this study was to define the rate of pyuria in children with KD and investigate the relation with other clinical and laboratory findings.Methods: In a prospective study, we evaluated all cases of KAWASAKI DISEASE referred to our center during 2002 to 2010 according to AAP definition. All patients were treated at Imam-Reza hospital (a university hospital with 995 beds) in Mashhad (a city in northeastern of Iran). Pyuria was defined as. 10 WBCs /HPF in the urine.Results: Pyuria was present in 42 (40.8%) of 103 children with KD. Children with KD and pyuria had more vomiting (P = 0.036), higher PMN in blood profile (P = 0.034) and elevated ALT (P = 0.034) in relation to children with KD without pyuria. The presence of pyuria was associated with less cardiac involvement in these patients but statistically insignificant (P = 0.057).Conclusion: Pyuria is common in children with KD. There was not any increased risk of cardiac involvement in children with KD and pyuria.