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Background: Studies on Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki Disease (KD) have yielded inconsistent results and are lacking in Asian and African countries. This study aimed to compare the laboratory and clinical features, short-term outcomes, and one-year follow-ups of a large cohort of MIS-C and KD patients. Methods: Data from 176 MIS-C and 56 KD patients admitted to Tehran Children's Medical Center between January 2021 and January 2022 were collected. Patients were followed up until January 2023. Results: While lymphopenia and thrombocytopenia were more prevalent in MIS-C (73.2% vs. 20% in KD, p < 0.001), KD patients exhibited a higher median white blood cell count and prevalence of anemia, along with higher fibrinogen and erythrocyte sedimentation rate levels (p < 0.001, p < 0.001, p = 0.005, p < 0.001, respectively). MIS-C patients also exhibited lower ejection fraction, a greater occurrence of pericardial effusion, and a higher incidence of coronary aneurysms and ectasia, and ascites. Echocardiography after seven days of treatment showed a reduction in pathologies for both groups, but it was significant only for MIS-C. After one year, coronary artery abnormalities remained in only six cases. Conclusions: In conclusion, this study highlights differences between MIS-C and KD, including laboratory indices as well as echocardiographic and abdominal ultrasound findings. These findings contribute valuable data on Iranian patients to the existing literature on this topic and have significant implications for accurate diagnosis and improved management of pediatric patients presenting with these conditions. [ABSTRACT FROM AUTHOR]

Background and Objective: One of the leading causes of acquired heart disease in the world today is Kawasaki disease [KD], an acute systemic vasculitis in children. The purpose of this study was to identify the clinical and laboratory manifestations of children with KD admitted to the 17th Shahrivar Educational Hospital in Rasht, Iran. Methods: We retrospectively studied the cases of 75 children with KD who were admitted to the 17th Shahrivar Educational Hospital in Rasht between 2011 and 2018. The frequency distribution of age, sex, seasonal prevalence, clinical manifestations including fever, skin rash, changes in the lips and oral cavity, conjunctivitis, changes in the extremities, and cervical lymphadenopathy; laboratory findings including platelets and leukocyte count, erythrocyte sedimentation rate [ESR], and C-reactive protein [CRP]; and response to treatment were studied. The obtained data were analyzed using descriptive statistical methods. Findings: Out of 75 patients, the most common clinical manifestations were fever [100%], skin rash [78.67%], alterations to the lips and mouth [74.67%], bilateral non-purulent conjunctivitis [64%], changes in the extremities [46.67%], and cervical lymphadenopathy [38.67%], respectively. Among 75 patients, 70 [93.33%] had ESR above 40 mm/h, and 63 patients [84%] had high C-reactive protein [CRP]. Sixty percent of children had incomplete Kawasaki disease. Eight of our patients [10.6%] developed coronary heart disease. Conclusion: In this study, the most frequent principal clinical manifestations were fever, skin rash, and alterations in the oral cavity and lips. Cervical lymphadenopathy had the lowest prevalence. Increased ESR and CRP were also the most common laboratory findings. [ABSTRACT FROM AUTHOR]

Background: Opium consumption is associated with increased risk of atherosclerosis and a hyper-inflammatory state which are suggested as contributing factors to the development of coronary artery ectasia (CAE). We aimed to determine if opium consumption is an independent risk factor of CAE. This study aimed to explore the relationship between opium consumption and CAE. Methods: In this propensity score-matched study, we enrolled patients who underwent elective coronary angiography between September 2004 and March 2017 in Tehran Heart Center. We studied patients with CAE and without coronary artery disease (CAD) as cases. The control group, patients with normal coronary angiograms, were selected after applying the propensity score matching to match for age, sex, diabetes mellitus, hypertension, hyperlipidemia, family history of coronary artery disease, and cigarette smoking. Results: We studied 242 patients with pure CAE and selected 968 control patients. The prevalence of opium consumption was not significantly different across these groups: 17 (7.5%) in the pure CAE group compared to 76 (8.6%) in the control group (Odds ratio: 0.81; P = 0.455). Amongst the patients with pure CAE, Markis scores were not significantly different between opium consumers and non-consumers (P = 0.136). Conclusion: We found no significant difference regarding opium consumption between patients with pure CAE and those with normal coronary angiograms. In addition, there was no correlation between opium consumption and Markis scores in patients with pure CAE. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction: Coronary artery aneurysms (CAAs) and ectasia (CAE) are diseases that have been increasingly noticed as the increase in utilization of coronary angiograms. Objective: The aim of this study is to determine the prevalence of coronary artery aneurysms and ectasia and describe the patients admitted to a private clinic in 2012 to 2014. Materials and Methods: This is a retrospective cross-sectional study involved all patient with invasive coronary angiogram that was performed at Dr.Heshmat and Golsar hospital in Rasht from may 2012 to may 2014. All data included cardiovascular disease major rick factors, demographic and angiographic characteristics were recorded in check list. Statistical analyses were performed by using SPSS version 19. Results: A total of 1705 coronary angiography were performed during the period of the study. CAE was found in 216 patients (12.7 % of all coronary angiograms). The majority (54.6%) were male. The mean age was 61.34±9.44 years (range, 30 to 83 years). CAE was associated with significant coronary artery stenosis in 123 patients (56.9%).The frequency of arterial involvement was: the right coronary artery (RCA) 56.9 %; left circumflex artery (LCx), 56.9%; the left anterior descending artery (LAD), 51.9 %.Coronary ectasia involved a single vessel in 50.9 %, two vessels in26.9 %, and three vessels in 20.4 %. Hyperlipidemia (81.5%) and hypertension (73.6%) were also most comorbidty in these patients. Coronary artery aneurysm was found in 7 patients (0.4% of all coronary angiograms). Conclusion: The prevalence of coronary artery ectasia in this study among patient who went for coronary angiography is higher than what has been published in others studies [ABSTRACT FROM AUTHOR]