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N-terminal pro-brain natriuretic peptide can be an adjunctive diagnostic marker of hyper-acute phase of Kawasaki disease

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Abstract

The purpose of this study was to determine whether the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level could be a useful marker for Kawasaki disease in the pediatric emergency department (PED) and in the presence of fever duration of 4 days or less (hyper-acute phase of Kawasaki disease). Medical records of patients who were 1 month to 15 years old of age and presented at the PED with suspected Kawasaki disease from January 1, 2010, to December 31, 2014, were collected retrospectively. Two hundred thirty-nine patients with a history of fever for 4 days or less were diagnosed with Kawasaki disease, as well as 111 patients with other febrile diseases, and were enrolled. The NT-proBNP level was significantly higher in patients with Kawasaki disease (Kawasaki disease vs. other febrile disease group, 444.8 (189.7–951.5) vs. 153.4 (68.9–287.6) pg/mL; p < 0.001), and a cutoff value of 244.7 pg/mL yielded a sensitivity and specificity of 68.6 and 70.3 %, respectively. The area under the curve of the NT-proBNP for predicting Kawasaki disease was 0.763 (95 % CI 0.712–0.814).

Conclusion: NT-proBNP might be an adjunctive laboratory marker for hyper-acute phase of Kawasaki disease in the PED.

What is Known:

• N-terminal pro-brain natriuretic peptide level has been reported as a useful marker for diagnosis in patients with the acute phase of Kawasaki disease.

• But, in the cases of less than 5 days of fever, the appropriate level of NT-proBNP for differentiating Kawasaki disease in PED has not been yet evaluated.

What is New:

• NT-proBNP might be an adjunctive laboratory marker for hyper-acute phase of Kawasaki disease.

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Abbreviations

AUC:

Area under curve

CI:

Confidence interval

NT-proBNP:

N-terminal pro-brain natriuretic peptide

PED:

Pediatric emergency department

ROC:

Receiver operating characteristic

SD :

Standard deviation

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Authors’ contributions

Hyuksool Kwon carried out the initial analyses, drafted the initial manuscript, and approved the final manuscript as submitted. Jin Hee Lee performed the data collection, drafted the initial manuscript, and approved the final manuscript as submitted. Jae Yun Jung, Do Kyun Kim, Jin Hee Jung, Ikwan Chang, and Kyuseok Kim reviewed and revised the manuscript and approved the final manuscript as submitted. Young Ho Kwak conceptualized and designed the study, supervised the data collection, reviewed and revised the manuscript, and approved the final manuscript as submitted.

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Authors and Affiliations

  1. Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea

    Hyuksool Kwon, Jae Yun Jung & Kyuseok Kim

  2. Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea

    Jin Hee Lee, Young Ho Kwak, Do Kyun Kim & Ikwan Chang

  3. Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea

    Young Ho Kwak

  4. Department of Emergency Medicine, Seoul National University Boramae Hospital, Seoul, Republic of Korea

    Jin Hee Jung

Authors
  1. Hyuksool Kwon
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  2. Jin Hee Lee
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  7. Ikwan Chang
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  8. Kyuseok Kim
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Corresponding author

Correspondence to Young Ho Kwak.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no competing interests.

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The authors have no financial relationships relevant to this article to disclose.

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Kwon, H., Lee, J.H., Jung, J.Y. et al. N-terminal pro-brain natriuretic peptide can be an adjunctive diagnostic marker of hyper-acute phase of Kawasaki disease. Eur J Pediatr 175, 1997–2003 (2016). https://doi.org/10.1007/s00431-016-2798-3

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  • DOI: https://doi.org/10.1007/s00431-016-2798-3

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