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Acute-Phase Reactants and a Supplemental Diagnostic Aid for Kawasaki Disease

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Abstract

The diagnosis of acute Kawasaki disease (KD) is based on characteristic clinical signs and not on a specific diagnostic test. The authors performed a comprehensive evaluation of acute-phase reactants in KD to determine which of the acute-phase reactants would most accurately distinguish KD from other febrile illnesses. Blood was collected from 218 cases of febrile children with KD (64 cases); bacterial pneumonia (74 cases); hand, foot, and mouth disease (31 cases); and upper respiratory tract infection (49 cases) in acute-stage illness before any therapy. The demographics, body temperature, and laboratory markers including white blood cell count, red blood cell count, and levels of hemoglobin, platelets, C-reactive protein, haptoglobin, apolipoprotein A-I, and apolipoprotein B were evaluated. Using post hoc analysis, the platelet count (103/μl) and haptoglobin/apolipoprotein A-I ratio were significantly higher for the KD patients (404.64 ± 161.68, P = 0.004; 4.74 ± 2.73, P < 0.001) than for the other groups including patients with pneumonia (272.76 ± 115.07, 2.03 ± 1.88); hand, foot, and mouth disease (274 ± 105.9, 2.24 ± 1.19); and upper respiratory tract infection (282.06 ± 107.72, 1.4 ± 0.98). The best cutoff value of the haptoglobin/apolipoprotein A-I ratio obtained from receiver operating characteristics (ROC) curves for KD was 2 (area under the ROC curve, 0.88; 95% confidence interval, 0.801–0.955), with a sensitivity of 89.7% and a specificity of 85.6% for detecting KD. Our data indicate that the serum haptoglobin/apolipoprotein A-I ratio could be a useful supplemental laboratory marker for the acute phase of KD.

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Authors and Affiliations

  1. Department of Radiation Oncology, Cancer Center, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan

    Ming-Yii Huang

  2. Department of Pediatrics, Division of Pediatric Cardiology, Children’s Memorial Hermann Hospital, University of Texas-Houston Medical School, 6411 Fannin Houston, Texas, 77030, USA

    Monesha Gupta-Malhotra

  3. Department of Family Medicine, Yuan’s General Hospital, No. 162 Cheng Kung 1st Road, Kaohsiung, 80249, Taiwan

    Joh-Jong Huang

  4. The Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD, 21205, USA

    Fei-Kai Syu

  5. Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung, 807, Taiwan

    Teh-Yang Huang

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  1. Ming-Yii Huang
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  2. Monesha Gupta-Malhotra
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  3. Joh-Jong Huang
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  4. Fei-Kai Syu
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  5. Teh-Yang Huang
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Correspondence to Teh-Yang Huang.

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M.Y. Huang and J.J. Huang contributed equally, and both considered the first author.

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Huang, MY., Gupta-Malhotra, M., Huang, JJ. et al. Acute-Phase Reactants and a Supplemental Diagnostic Aid for Kawasaki Disease. Pediatr Cardiol 31, 1209–1213 (2010). https://doi.org/10.1007/s00246-010-9801-y

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  • DOI: https://doi.org/10.1007/s00246-010-9801-y

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