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Unilateral cervical mass and fever were firstly misdiagnosed as bacterial lymphadenitis in a 6-year-old child and empirically treated with antibiotics. Later the child developed the additional features of Kawasaki syndrome and received intravenous immunoglobulins at the eighth day since fever onset with progressive disappearance of the cervical mass and no cardiac sequel. Kawasaki syndrome should be considered in childhood as a relevant cause of cervical lymphadenopathy unresponding to antibiotics: its recognition at an early stage might contribute to anticipate a proper treatment and abate heart complication rate. © 2007 Springer-Verlag.

Early-onset osteoporosis with high bone turnover is presented for pediatric patients affected by mucopolysaccharidosis type IV or Morquio-Brailsford syndrome

Predictive factors of renal involvement or relapsing disease in children with Henoch-Schönlein purpura (HSP) are poorly known. We examined clinical and laboratory variables concerning HSP evolution in children hospitalized in the last decade to predict the possibility of renal complications or relapse occurrence. Periodic clinical evaluations with urinalysis were performed for 6 ± 3.6 years. Simple logistic regression showed that persistent rash and severe abdominal pain at the onset of HSP are significantly related to renal involvement, while persistent rash is significantly related to relapsing disease. Multiple logistic regression showed that persistent rash remains related to renal involvement when adjusted for sex, age, and severe abdominal pain and conversely that severe abdominal pain is not related to renal involvement when adjusted for sex, age, and persistent rash. In conclusion, persistent rash over a period longer than 1 month seems to represent a significant predictor of renal sequelae and disease relapse in children with HSP. © Springer-Verlag 2004.