Childhood and adulthood obesity has reached epidemic levels. Unfortunately, obesity tracks from childhood into adulthood and its persistence rises with age among obese children. Childhood obesity is associated with comorbidities, which are present even in childhood, including hypertension, endothelial dysfunction, insulin resistance and type 2 diabetes (T2D), fatty liver disease, obstructive sleep apnea and endocrine, musculoskeletal and psychosocial problems. Early onset obesity is a risk factor for morbidity and mortality later in life. The main causes of death of obese children and adolescents in adulthood include cardiovascular diseases, T2D and its complications, obstructive sleep apnea and cancer. Morbidity and mortality increase proportionately to the severity and duration of childhood obesity. Furthermore, body mass index (BMI) is associated with projected life expectancy. Decreased life expectancy is observed among obese, but also among lean individuals, with the best life expectancy being observed among normal weight and overweight people. Life expectancy has halted at present and further decrease due to the obesity epidemic is expected, if proper measures are not taken. The association between childhood obesity and adult morbidity and mortality strongly suggests that more effective prevention and treatment of childhood obesity should be pursued.

Kawasaki disease constitutes an acute febrile vasculitis of unknown aetiology. It is considered the most common cause of acquired cardiac failure in children. Although standard treatment comprises intravenous immunoglobulin and aspirin, some children exhibit refractory disease, necessitating the use of alternative therapies such as corticosteroids and anti-tumour necrosis factor-alpha. For these cases, few controlled data are available. This report focuses on an extremely refractory classical Kawasaki disease with coronary artery aneurysms and ongoing inflammation. We discuss the therapeutic approaches and the potential pitfalls undertaken, which led to an unfavourable clinical outcome.