{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T10:24:20Z","timestamp":1764584660710,"version":"3.46.0"},"reference-count":45,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Reports"],"abstract":"<jats:p>Background: Kawasaki Disease (KD) is an acute vasculitis affecting children under five years of age, with atypical presentations posing diagnostic challenges and a higher risk of coronary complications when untreated. Methods: We report on a 2-year-old girl with persistent fever, limb edema, erythema, and non-purulent conjunctivitis, without cervical lymphadenopathy or the typical rash. Inflammatory markers were assessed, and a cytokine expression profile was obtained using qRT-PCR. Results: Laboratory analysis showed elevated C-reactive protein (11.1 mg\/dL), high fibrinogen (468 mg\/dL), borderline D-dimer (484 ng\/mL), and a normal platelet count. The cytokine profile revealed marked upregulation of IFN-\u03b1, IFN-\u03b2, IFN-\u03b3, IL-1\u03b1, IL-1\u03b2, IL-5, IL-8, and IL-12, with downregulation of IL-2 and IL-4, as well as low TNF-\u03b1 levels. These findings, although not pathognomonic, were consistent with an inflammatory profile compatible with atypical KD, in which a preceding viral infection may have played a role, although causality cannot be established. Conclusions: This case highlights the diagnostic utility of cytokine profiling in suspected atypical KD, particularly when clinical criteria are incomplete. The integration of immunological data may aid in earlier recognition and therapeutic intervention, thereby helping to prevent cardiovascular sequelae. Cytokine analysis may serve as a promising adjunct for atypical KD diagnosis, although confirmation in larger cohorts is needed.<\/jats:p>","DOI":"10.3390\/pediatric17060128","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T09:34:37Z","timestamp":1764581677000},"page":"128","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immunological Profile in Atypical Kawasaki Disease: A Case Report Highlighting the Diagnostic Utility of Cytokine Analysis by qRT-PCR"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1478-9068","authenticated-orcid":false,"given":"Margarita L.","family":"Martinez-Fierro","sequence":"first","affiliation":[{"name":"Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Universidad Autonoma de Zacatecas, Carretera Zacatecas-Guadalajara Km.6. Ejido la Escondida, Zacatecas 98160, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6307-1696","authenticated-orcid":false,"given":"Idalia","family":"Garza-Veloz","sequence":"additional","affiliation":[{"name":"Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Universidad Autonoma de Zacatecas, Carretera Zacatecas-Guadalajara Km.6. Ejido la Escondida, Zacatecas 98160, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7796-2586","authenticated-orcid":false,"given":"Felipe D.","family":"Marrufo-Garcia","sequence":"additional","affiliation":[{"name":"Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Universidad Autonoma de Zacatecas, Carretera Zacatecas-Guadalajara Km.6. Ejido la Escondida, Zacatecas 98160, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5477-3256","authenticated-orcid":false,"given":"Manuel","family":"Gonzalez-Plascencia","sequence":"additional","affiliation":[{"name":"Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Universidad Autonoma de Zacatecas, Carretera Zacatecas-Guadalajara Km.6. Ejido la Escondida, Zacatecas 98160, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rocio C.","family":"Calderon-Zamora","sequence":"additional","affiliation":[{"name":"Hospital General de Zona No.1, Mexican Social Security Institute for Welfare (IMSS-BIENESTAR), Zacatecas 98040, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Sifuentes-Franco","sequence":"additional","affiliation":[{"name":"Hospital General de Zona No.1, Mexican Social Security Institute for Welfare (IMSS-BIENESTAR), Zacatecas 98040, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Rodriguez-Borroel","sequence":"additional","affiliation":[{"name":"Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Universidad Autonoma de Zacatecas, Carretera Zacatecas-Guadalajara Km.6. Ejido la Escondida, Zacatecas 98160, Mexico"},{"name":"Hospital General de Zona No.1, Mexican Social Security Institute for Welfare (IMSS-BIENESTAR), Zacatecas 98040, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e481","DOI":"10.1161\/CIR.0000000000001295","article-title":"Update on Diagnosis and Management of Kawasaki Disease: A Scientific Statement From the American Heart Association","volume":"150","author":"Jone","year":"2024","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1136\/archdischild-2014-307536","article-title":"The epidemiology of Kawasaki disease: A global update","volume":"100","author":"Singh","year":"2015","journal-title":"Arch. Dis. 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