Clinical Characteristics and Serum N-terminal Pro-brain Natriuretic Peptide As a Diagnostic Marker of Kawasaki Disease in Infants Younger Than 3 Months of Age

Overview

Journal Korean J Pediatr

Specialty Pediatrics

Date 2014 Sep 12

PMID 25210523

Citations 3

Authors

Hyun Kyung Bae

Do Kyung Lee

Jung Hyun Kwon

Hae Soon Kim

Sejung Sohn

Young Mi Hong

Affiliations

Soon will be listed here.

Abstract

Purpose: The incidence of Kawasaki disease (KD) is rare in young infants (less than 3 months of age), who present with only a few symptoms that fulfill the clinical diagnostic criteria. The diagnosis for KD can therefore be delayed, leading to a high risk of cardiac complications. We examined the clinical characteristics and measured the serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels of these patients for assessing its value in the early detection of KD.

Methods: We retrospectively reviewed the data of young infants diagnosed with KD from 2004 to 2012. The control group included 20 hospitalized febrile patients. Laboratory data, including NT-proBNP were obtained for each patient in both groups.

Results: Incomplete KD was observed in 21/24 patients (87.5%). The mean fever duration on admission was 1.36±1.0 days in the KD group. Common symptoms included erythema at the site of Bacille Calmette-Guerin inoculation (70.8%), skin rash (50.0%), changes of oropharyngeal mucosa (29.1%), and cervical lymphadenopathy (20.8%). The mean number of major diagnostic criteria fulfilled was 2.8±1.4. Five KD patients (20.8%) had only one symptom matching these criteria. The incidence of coronary artery complications was 12.5%. The mean serum NT-proBNP level in the acute phase, in the KD and control groups, were 4,159±3,714 pg/mL and 957±902 pg/mL, respectively, which decreased significantly in the convalescent phase.

Conclusion: Incomplete KD was observed in 87.5% patients. Serum NT-proBNP might be a valuable biomarker for the early detection of KD in febrile infants aged <3 months.

Citing Articles

Differentiation between incomplete Kawasaki disease and secondary hemophagocytic lymphohistiocytosis following Kawasaki disease using N-terminal pro-brain natriuretic peptide.

Choi J, Kwak Y, Huh J, Yoo E, Ryu K, Sohn S Korean J Pediatr. 2018; 61(5):167-173.

PMID: 29853942 PMC: 5976567. DOI: 10.3345/kjp.2018.61.5.167.

Incomplete Kawasaki disease: The usefulness of BCG reactivation as a diagnostic tool.

Suliman O, Abdelnasser M Sudan J Paediatr. 2016; 12(1):84-8.

PMID: 27493333 PMC: 4949825.

Cardiac Function in Kawasaki Disease Patients with Respiratory Symptoms.

Lee S, Choi H, Son S, Hong Y Korean Circ J. 2015; 45(4):317-24.

PMID: 26240586 PMC: 4521110. DOI: 10.4070/kcj.2015.45.4.317.

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