Background: KAWASAKI DISEASE (KD) is a systemic syndrome of inflammatory with unknown cause and usually occurs in children. It is the most common cause of acquired heart DISEASE in industrialized countries.Objectives: The aim of this study was to examine the course of cardiovascular involvement in patients with KD after treatment with intravenous immunoglobulin and aspirin.Patients and Methods: This retrospective study was performed on all children who were admitted with diagnosis of KD and had received intravenous immunoglobulin therapies and aspirin in Ali Ibne Abi Talib hospital during 2004 to 2013 years. Analysis was done by SPSS-20 with 0.05 as significant level.Results: Out of 53 patients, 60% were male. Early involvement of the right and left coronary heart DISEASE were 20.75% and 26% respectively. The frequency of aneurysm for left and right coronary artery was 3 (5%) cases. The mean of left coronary artery and right coronary artery diameters in before and after treatment were 2.39±0.84, 1.95±0.72 and 2.12±0.54, 1.81±0.31 mm respectively and they had significant differences (P = 0.001). The means of duration of fever for with and without coronary aneurysm (13±4.2 vs. 8.8±2.8 days), sedimentation rate (121.5±21 vs. 73.9±29.8 mm) and alkaline phosphatase (808±101 vs. 476±148 Iu/L) in patients with KD had significant difference of P = 0.04, P = 0.03 and P = 0.003 respectively.Conclusions: We found coronary artery DISEASE and aortic aneurysm is almost similar to other studies and showed age, duration of fever onset, intravenous immunoglobulin, sedimentation and alkaline phosphatase have a role in coronary involvement and aneurysm.

Introduction: As COVID-19 spreads rapidly all over the world and nations struggle to control it, the novel presentations of SARSCoV-2 infection and its possible triggering role for other DISEASEs in pediatrics concern clinicians in frontlines. Case Presentation: We describe a 10-year-old child diagnosed with COVID-19 infection and concurrent KAWASAKI DISEASE. He presented with prolonged fever and conjunctivitis. His initial echocardiogram showed coronary artery dilation in RCA. He was treated with IVIG and aspirin as per guidelines and discharged 48 hours after the completion of IVIG and diminishing fever. His follow-up echocardiogram showed improvement in a two weeks’ interval while he was quarantined in the meantime and showed no respiratory complications. Conclusions: In conclusion, we think that there might be a correlation between COVID-19 infection and hyperinflammatory conditions, like KAWASAKI DISEASE. Further investigations are needed to enlighten the complications caused by COVID-19 infection, especially in pediatrics. In addition, we emphasize follow-up visits (in person or long-distance) in pediatrics presenting with inflammatory symptoms.

KAWASAKI DISEASE (KD) is an inflammatory vasculitis. KD is classified into two groups based on clinical characteristics criteria, namely classic and incomplete. Cerebral vascular abnormality, especially arterial ischemic stroke (AIS) is very rare and unusual in KD. Here, we report a 4-year-old boy who was referred to our tertiary pediatric center with abrupt right hemiparesis and aphasia. At admission time, he had febrile illness and was toxic. On physical examination, we found unilateral left submandibular lymphadenopathy. On neurologic examination, we obtained right sided hemiparesis with hemiparetic gait and aphasia. His deep tendon reflexes (DTRs) of right extremities were exaggerated and his sensory system was intact. Based on these features, some differential diagnoses were suggested, such as acute encephalitis with focal signs, brain abscess, cerebral vasculitis, hemorrhagic insults, and ischemic stroke, etc. After a complete evaluation, especially brain MRI and MRA, our diagnosis was arterial ischemic stroke (AIS) following atypical KD. Based on these findings, we administered intravenous immunoglobulin (IVIG 2 gm/kg) and oral high dose aspirin (100 mg/kg/d). He responded to these anti-inflammatory treatments dramatically.

Background: The current study was done to identify key genes associated with KAWASAKI DISEASE (KD). Methods: Three datasets were collected from Gene Expression Omnibus (GEO) database. Then, differentially expressed genes (DEGs) analysis, gene ontology (GO) annotation, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were performed. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to determine the expression levels of DEGs in KD. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic value of DEGs. Results: In total, 2923 DEGs (1239 up-and 1684 down-regulated genes) were detected in KD. Ribosome, Leishmaniasis, and Tuberculosis significantly enriched KEGG pathways of DEGs. Six DEGs, including ADM, S100A12, ZNF438, MYD88, FCGR2A, and FCGR3B, were selected for qRT-PCR validation. Except for MYD88, the qRT-PCR results displayed similar expression patterns with that in our integrated analysis. ROC analysis revealed the diagnostic value of the six DEGs. Conclusions: Our study was expected to provide clues toward understanding the pathophysiology of KD inflammation.

KAWASAKI DISEASE (KD) is the most common cause of acquired heart DISEASE today. An important and enduring complication of KD is a coronary aneurysm, whose early diagnosis and treatment can reduce the risk from 25% to 3%. Diagnosis of this DISEASE is mainly clinical, although leukocytosis, increased erythrocyte sedimentation rate, and echocardiography are helpful in diagnosis. The cause of KD remains unknown, but the most common hypothesis is an abnormal immune response that is likely caused by an infectious agent, possibly in a favorable genetic background, and leads to vasculitis of the middle arteries, especially coronary arteries of the heart. Numerous infectious agents have been suggested in this regard. Co-infection with KD can also delay diagnosis. In this article, we introduce five years and seven months child who developed KAWASAKI DISEASE within a few days of the onset of Epstein-Barr virus infection.

KAWASAKI DISEASE is an acute inflammatory disorder of medium-sized arteries that predominantly affects cardiac coronary arteries and children under the age of 5 years. Cardiac involvement usually happens later than 10 days after the onset of illness. Most of cardiac complications are coronary artery abnormalities (ectasia or aneurysms) and subclinical myocarditis. Clinical myocarditis (symptomatic congestive heart failure), pericarditis, valvulitis and pericardial effusion, as well as pancarditis are rare. This paper reports a 5-year-old boy who had heart failure (ejection fraction 48%) in the acute stage of KAWASAKI DISEASE and pericarditis. He was admitted to the hospital following 3 days of continuous fever, bilateral cervical adenopathy and dominant right side neck of torticollis. The results of physical examination after 5 days showed typical KAWASAKI DISEASE. Cardiac examination also revealed cardiac murmur and gallop rhythm. In laboratory tests, mild liver dysfunction, hypoproteinemia and hyponatremia were discovered. During hospitalization, troponin levels were positive. The patient was treated with oral high dose aspirin (100 mg/kg/d), two doses of intravenous immunoglobulin (IVIG 2 gm/kg) and three pulses of methylprednisolone. Two weeks later, cardiac evolvements were improved without further complications. The patient exhibited dramatically clinical recovery and was healthy after 8 weeks of follow-up. This case indicates that Lymph-node-first presentation of KAWASAKI DISEASE could be examined in children with KAWASAKI DISEASE who exhibit symptoms of congestive cardiac failure, pericardial effusion and pericarditis during the acute phase of the DISEASE. . .