Korean J Pediatr.  2016 Jul;59(7):298-302. 10.3345/kjp.2016.59.7.298.

Age-adjusted plasma N-terminal pro-brain natriuretic peptide level in Kawasaki disease

• Jun H
• Ko KO
• Lim JW
• Yoon JM
• Lee GM
• Cheon EJ

• KMID: 2350051
• DOI: http://doi.org/10.3345/kjp.2016.59.7.298

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.

Keyword

Mucocutaneous lymph node syndrome; NT-proBNP; Child; Coronary artery lesion

MeSH Terms

Aspartate Aminotransferases
C-Reactive Protein
Child
Coronary Vessels
Diagnosis
Humans
Immunoglobulins
Immunoglobulins, Intravenous
Infant
Leukocyte Count
Mucocutaneous Lymph Node Syndrome*
Neutrophils
Peptides
Plasma*
Reference Values
Retrospective Studies
Troponin I
Aspartate Aminotransferases
C-Reactive Protein
Immunoglobulins
Immunoglobulins, Intravenous
Peptides
Troponin I