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ORIGINAL ARTICLE
Korean J Pediatr 2014 August;57(8) :357-362.
Published online 2014 March 14.       
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
Hyun Kyung Bae1, Do Kyung Lee1, Jung Hyun Kwon1, Hae Soon Kim1, Sejung Sohn1, Young Mi Hong1,2
1Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
1,2Ewha Womans University Global Top 5 Research Program, Seoul, Korea
Corresponding Author: Young Mi Hong ,Tel: +82-2-2650-2841, Fax: +82-2-2653-3718, Email: ymhong@ewha.ac.kr
Copyright © 2014 by The Korean Pediatric Society
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 NTproBNP 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 1.361.0 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 2.81.4. 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 4,1593,714 pg/mL and 957902 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.
Keywords: Kawasaki disease | Infant | Brain natriuretic peptide
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