Adjuvant Laboratory Marker of Kawasaki Disease; NT-pro-BNP or hs-CRP?

  1. Hee Joo Lee1
  1. 1Department of Laboratory Medicine, School of Medicine, Kyung Hee University
  2. 3Department of Pediatrics, School of Medicine, Kyung Hee University
  3. 2Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
  1. Address correspondence to: Hee Joo Lee, MD, Ph.D and Mi Young Han3, MD, Ph.D; Department of 1Laboratory Medicine and 3Pediatrics, School of Medicine, Kyung Hee University,1 Hoegidong, Dongdaemun-gu, Seoul 130-702, Korea; tel: + 82 2 958 8672; fax: + 82 2 958 8609; e-mail; leehejo{at}khmc.or.kr and myhan44{at}naver.com

Abstract

Background The diagnosis of Kawasaki disease (KD) is based on clinical data and non-pathognomonic symptoms. As no specific diagnostic test for KD exists, BNP or NT-pro-BNP might be of importance in identifying KD. We compared serum hs-CRP and NT-pro-BNP level in the acute phase of 59 KD patients and evaluated the diagnostic performance of these laboratory markers in KD to estimate the cut-off level for differentiating KD from other febrile illnesses as age-matched controls.

Materials and Methods The study groups consisted of 59 KD patients in the disease group and 45 other patients with febrile illnesses as age-matched controls. NT-pro-BNP was measured using Elecsys proBNP (Roche Diagnostics, Mannheim, Germany), and hs-CRP was tested with CardioPhase hs-CRP (Siemens Healthcare Diagnostics, Marburg, Germany).

Results NT-pro-BNP levels were significantly higher in the KD patients than in the controls (P < 0.001). In the ROC curve analysis, the sensitivity was 66.10%, and the specificity was 77.08% at 235.2 pg/mL. hs-CRP levels tended to be higher in KD patients compared to controls.

Discussion This study indicates that NT-pro-BNP might be a more useful laboratory marker as an adjuvant diagnostic tool for KD than hs-CRP. Especially in a patient with incomplete clinical features of KD, the diagnosis and the start of treatment were delayed to confirm a fever persisting for at least 5 days. Therefore, we expect that NT-pro- BNP would be especially useful for KD patients with these atypical clinical presentations.

This study was approved by IRB in Kyung Hee University Medical Center (KMC IRB 1024-01).

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