Pediatric Cardiology

, Volume 31, Issue 8, pp 1209–1213 | Cite as

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

  • Ming-Yii Huang
  • Monesha Gupta-Malhotra
  • Joh-Jong Huang
  • Fei-Kai Syu
  • Teh-Yang Huang
Original Article

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.

Keywords

Acute-phase reactants Apolipoprotein A-I Apolipoprotein B Haptoglobin Haptoglobin/apolipoprotein A-I ratio Kawasaki disease 

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Ming-Yii Huang
    • 1
  • Monesha Gupta-Malhotra
    • 2
  • Joh-Jong Huang
    • 3
  • Fei-Kai Syu
    • 4
  • Teh-Yang Huang
    • 5
  1. 1.Department of Radiation Oncology, Cancer CenterKaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical UniversityKaohsiungTaiwan
  2. 2.Department of Pediatrics, Division of Pediatric Cardiology, Children’s Memorial Hermann HospitalUniversity of Texas-Houston Medical SchoolTexasUSA
  3. 3.Department of Family MedicineYuan’s General HospitalKaohsiungTaiwan
  4. 4.The Johns Hopkins Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreUSA
  5. 5.Department of PediatricsKaohsiung Medical University Hospital, Kaohsiung Medical UniversityKaohsiungTaiwan

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