Since cell culture studies focus on isolated cells apart

Since cell-culture studies focus on isolated chemokine receptor antagonist apart from tissues or organisms, the influence of some elements that can interfere with the pharmacological receptors for example, including some chemical environments (), hormones and fluid pressure cannot be studied. Importantly, some pharmacokinetic parameters cannot be studied by cell cultures, and animal experiments remain required to achieve this purpose. Focusing on the challenges facing the application of cell culture techniques in drug discovery and overcoming them would further exploit this important method for drug discovery and drug development research.

Kawasaki disease was first described in 1967 by Tomisaku Kawasaki and has replaced acute rheumatic fever as the leading cause of acquired heart disease among children in developed countries (Taubert et al., 1991). KD is an acute, self-limited vasculitis of unknown etiology that occurs predominantly in infants and young children (Newburger et al., 2004). The exact etiology of KD remains unknown, although genetic predisposition or infectious agents are likely to be the cause.
Recently, guidelines were published by the American Heart Association (AHA) to aid in the diagnosis and management of Kawasaki disease. Some children classified as atypical KD patients because they present with incomplete clinical features of KD instead of classical criteria. Typical KD diagnosed by clinical criteria include fever 39–40°C for at least 5days, however it could be lasting for 11days if untreated with concurrent presence of four of other criteria or at least three if coronary artery aneurysms developed. Coronary artery aneurysms or ectasia develop in 15–25% of untreated children with the disease and may lead to myocardial infarction (MI), sudden death, or ischemic heart disease (Newburger et al., 2004). Other surrogate parameters can be elevated during acute phase include CRP and ESR however CRP test more accurate in case of patient recently treated with IVIG because IG can elevate ESR.
Children with acute KD are treated according to the past AHA recommendation guideline with single dose of IVIG (2g/kg) and a high dose aspirin (80–100mg/kg/d, divided into four doses). Aspirin continued indefinitely in patient with coronary artery abnormalities or until six to eight weeks in normal finding. Repeat IVIG in patients who failed to initial therapy those with persistent or recurrent fever >36h after completion of initial IVIG infusion.
The new data shows that it is unnecessary to expose children to high- or medium-dose aspirin therapy in acute KD when the available data show no appreciable benefit in preventing the failure of IVIG therapy or CAL formation or in shortening fever duration (Weng and Ou, 2011). Long term management of KD differs according to the risk level of coronary artery abnormalities.
G6PD deficiency is an inherited X-linked disorder. It causes a spectrum of disease including neonatal hyperbilirubinemia, acute hemolysis, and chronic hemolysis. Different gene mutations cause different levels of enzyme deficiency, with classes assigned to various degrees of deficiency and disease manifestation. The levels of enzyme deficiency categorized from severe, moderate, and mild to none (Frank, 2005).

Case report
5years and 8months old Saudi boy, 18kg weight was admitted to the pediatric department. Patient was healthy until 2weeks prior to admission, when he started to have gastroenteritis with fever and received treatment in another hospital for which diarrhea improved but fever persisted. Two days prior to admission, he was seen in pediatric clinic and diagnosed as case of tonsillitis with adenoid hypertrophy and treated with amoxicillin–clavulanate and planed for surgery, however his fever persisted and there was swelling of dorsum of both feet with inability to walk due to pain, so he came back for follow up and was advised to be admitted for query Kawasaki.