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Background and Aims: The Mexican population has a distinct capacity for the expression of tumor necrosis factor (TNF), a cytokine that plays a cardinal role in Kawasaki disease (KD), particularly in those who develop coronary aneurysms. It is important to identify, in Mexican pediatric patients, the association of the frequency of TNF. This study determined the association of TNF −308 and lymphotoxin-alpha (LTA) +252 polymorphisms in Mexican pediatric patients with KD and coronary aneurysms (CA). Methods: We conducted a cross-sectional, analytical study in 48 children with KD, 22 with CA. Control samples were obtained from 61 aged-matched children. We took a peripheral blood sample and extracted genomic DNA from all children participating in the study. Using restriction factor length polymorphism-polymerase chain reaction (RFLP-PCR), we performed determination of TNF −308 and LTA +252. Results: There was no difference in frequency between the study groups for genotype LTA +252 (OR 0.37, 95% CI, 0.06–2, p = 0.44) or between groups for KD with or without coronary aneurysms for both polymorphisms. In subjects with KD, we did not observe the heterozygous genotype of TNF –308, the difference being significant (OR 12, 95% CI, 4.8–30.4, p = 0.0001) using the χ2 test with the continuity correction on comparison with the control group. Conclusions: Comparative analysis by group did not show a significant difference in the frequency of the alleles and genotypes between KD with CA vs. KD without CA vs. controls, for both TNF −308 and LTA +252. [ABSTRACT FROM AUTHOR]

We report the case of a 2 year 7 month old boy with the diagnosis of incomplete and atypical Kawasaki disease, whom showed only two of the classical criteria: fever and conjunctival injection without exudate, presenting clinical manifestations that are reported less often, such as gallbladder hydrops, aseptic meningitis, arthralgia, sterile pyuria, coronary aneurysms and myocardial ischemia. This patient had recurrent and refractory Kawasaki disease not responding to treatment with intravenous immunoglobulin and thus requiring steroids and immunosuppressive management. [ABSTRACT FROM AUTHOR]

Objectives: To describe the clinical characteristics, outcome, and treatment response in a series of patients with Kawasaki disease (KD). Methods: Case-series, review of clinical records of children with KD diagnosis cared for from November 1999 to September 2006. Results: 22 patients were included, male:female ratio, 1.4:1, 82% younger than 5 years, 14% with atypical presentation. Of the 22 patients, 10 (45%) received intravenous gammaglobulin (IVGG) in the first 10 days of symptoms onset at the recommended dose; four of them had coronary artery damage but none developed residual aneurysmatic lesions. Eight received IVGG in a different dose or after 10 days, six of them had coronary lesions and in two the damase was permanent. Four patients did not receive IVGG, and two had residual aneurysmatic lesions. None of those who received adequate treatment developed coronary residual damage, in comparison with 33% who received inadequate or no treatment, but difference was not statistically significant (P = .06). Conclusions: KD is a rare clinical entity in our country; even though most of the cases occurred with classic clinical criteria, late referral and delay of treatment worsen the prognosis. [ABSTRACT FROM AUTHOR]