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ORIGINAL ARTICLE
Korean J Pediatr 2016 July;59(7) :298-302.
Published online 2016 July 15.        doi:https://doi.org/10.3345/kjp.2016.59.7.298
Age-adjusted plasma N-terminal pro-brain natriuretic peptide level in Kawasaki disease
Heul Jun, Kyung Ok Ko, Jae Woo Lim, Jung Min Yoon, Gyung Min Lee, Eun Jung Cheon
Department of Pediatrics, Konyang University College of Medicine, Daejon, Korea
Corresponding Author: Eun Jung Cheon ,Tel: +82-42-600-9230, Fax: +82-42-600-9090, Email: ejcheon000@kyuh.ac.kr
Copyright © 2016 by The Korean Pediatric Society
ABSTRACT
Purpose: Recent reports showed that plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) could be a useful biomarker of intravenous immunoglobulin (IVIG) unresponsiveness and coronary artery lesion (CAL) development in Kawasaki disease (KD). The levels of these peptides are critically influenced by age; hence, the normal range and upper limits for infants and children are different. We performed an age-adjusted analysis of plasma NT-proBNP level to validate its clinical use in the diagnosis of KD.
Methods: The data of 131 patients with KD were retrospectively analyzed. The patients were divided into 2 groups—group I (high NT-proBNP group) and group II (normal NT-proBNP group)—comprising patients with NT-proBNP concentrations higher and lower than the 95th percentile of the reference value, respectively. We compared the laboratory data, responsiveness to IVIG, and the risk of CAL in both groups.
Results: Group I showed significantly higher white blood cell count, absolute neutrophil count, C-reactive protein level, aspartate aminotransferase level, and troponin-I level than group II (P<0.05). The risk of CAL was also significantly higher in group I (odds ratio, 5.78; P=0.012). IVIG unresponsiveness in group I was three times that in group II (odds ratio, 3.35; P= 0.005).
Conclusion: Age-adjusted analysis of plasma NT-proBNP level could be helpful in predicting IVIG unresponsiveness and risk of CAL development in patients with KD.
Keywords: Mucocutaneous lymph node syndrome | NT-proBNP | Child | Coronary artery lesion
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