Background: KAWASAKI DISEASE (KD) is an acute vasculitis that affects small and medium-sized arteries. During the coronavirus DISEASE 19 (COVID-19) pandemic, a significant increase in KD symptoms was reported among patients who had taken COVID-19, known as the multisystem inflammatory syndrome in children (MIS-C). We describe 2 cases of KD following the COVID-19. Case presentation: Two 2. 5 and 3. 5 year-old boys presented to the Shahid Sadoughi Hospital with weakness, fever, nausea, and vomiting for several days. The other symptoms were maculopapular rash, cracked lips, erythematous palms, conjunctivitis, and lymphadenopathy. Respiratory symptoms were observed in none of them. The course of the DISEASE was moderate to severe in both, and they were treated entirely. Conclusions: COVID-19 infection in children may be presented without any respiratory symptoms. Thus, Pediatricians should consider these atypical presentations and not restrict COVID-19 tests only for patients with typical presentations in order not to miss such cases and prevent irreversible complications.

Background: KAWASAKI DISEASE (KD) is the most frequent cause of coronary artery aneurysm (CAA) in children. This study tried to evaluate the accuracy of different KD scores developed for prediction of CAA, in an Iranian population. Methods: This is a cross-sectional retrospective investigation on pediatric patients with a diagnosis of KD. Clinical manifestations, laboratory, and echocardiographic data were recorded. Five KAWASAKI scores, including Kobayashi, Egami, Sano, Nakano, and Harada, were assessed and analyzed in relation to CAA and intravenous immunoglobulin (IVIG) resistance. Results: During five years, we recruited 121 cases of KD under 13 years of age. The rates of CAA and IVIG resistance were 16. 5%, and 13. 2% respectively. The IVIG resistance group was significantly younger than responder patients. All five scores had low sensitivity in predicting CAA or IVIG resistant cases; the highest sensitivity pertained to the Harada score with 50% sensitivity and 59% specificity (the area under the curve: 0. 545, with a 95% confidence interval: 0. 423 to 0. 667) in predicting CAA, which is lower than the usual acceptable criteria for a screening test. The specificity of all other scores were more than 85% in predicting CAA or IVIG resistance. Gender, fever before therapy and laboratory data showed no significant difference between the groups. Conclusion: The Kobayashi, Egami, Sano, Nakano and Harada scores have limited usefulness in the Iranian population to predict high risk patients for coronary artery involvement or IVIG resistance; in our study, age under one year was a risk factor for IVIG resistance.

Background and Objective: KAWASAKI DISEASE is the common acquired heart DISEASE in children.KAWASAKI DISEASE is a vasculitis that predominantly affects the medium-sized arteries, with a striking predilection for the coronary arteries. This study was done to determine the relationship between coronary aneurysm formation and neutrophylia, in childern with KAWASAKI DISEASE.Method: This descriptive-analytic study was done on 80 children (45 Males, 35 Females) with typic and atypical KAWASAKI DISEASE in Afzalipoor hospital, Kerman, Iran during 2011-13. According to transthoracic echocardiography, patients were divided into childern with and without coronary aneurysm.CBC count, ESR and Peripheral blood smear was performed for each subject.Results: White blood cells, neutrophils, platlets and ESR in childern with coronary aneurysm, was nonsignificantly more than without aneurysm. Duration of fever in chidern without aneurysm was nonsignificantly more than childern with coronary aneurysm.Conclusion: Neutrophils counting by itself is not sufficient critria for the prediction of the aneurysm risk in kawazaki DISEASE.

KAWASAKI DISEASE (KD) is an acute febrile mucocutaneous lymph node syndrome with multisystem vasculitis mainly affecting infants and children less than 5 years of age, first described by Tomisaku KAWASAKI from Japan in 1967. In the absence of a diagnostic test for KD, the diagnosis is established when fever and four of the remaining five principal symptoms are present. In this report we describe 3 children who presented atypically with prolonged fever and congestive heart failure (CHF) that does not belong to principal symptomatology of KD.

Background and Purpose: The clinical and epidemiologic features of KAWASAKI DISEASE (KD) suggest an infectious etiology; however, the agent(s) remain unknown. Our purpose was to isolate the causative bacterial gene from peripheral blood leukocytes of patients with acute KD, by Universal polymerase chain reaction (UPCR), in Tehran Children's Medical Center.Materials and Methods: Universal polymerase chain reaction (UPCR) assay was used to amplify the bacterial16S ribosomal RNA gene (rDNA).Results: Forty three (28 boys and 15 girls) were diagnosed with acute KAWASAKI DISEASE included in this study. The median age at diagnosis was 3.5 years (range: 0.5 -9 years). Twenty Nine (29) cases had typical KD criteria and 14 patients had atypical KD at diagnosis. Two of the 43 KD patients were positive for the Universal PCR assay for 16S rRNA, prior to intravenous g-globulin therapy (IVGT), while all specimens were negative by conventional blood culture. In our study, there was fever in 100%, conjunctivitis in 62.7%, rash in 83.72%, oral mucosal changes in 76.74%, peripheral changes in 37.20%, and cervical lymphadenopathy in 39.53% cases.Conclusion: The 16S rDNA sequence was positive in 4.65% of acute KD patients; this data shows that an infectious KD agent is traced in peripheral leukocytes. The question remains as to what true frequency ofthe16S rDNA sequence in KD is.