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http://dx.doi.org/10.3345/kjp.2010.53.4.519

NT-proBNP as a useful tool in diagnosing incomplete Kawasaki disease  

Lee, Dong-Won (Department of Pediatrics, Kyungpook National University School of Medicine)
Kim, Yeo-Hyang (Departments of Pediatrics, Keimyung University School of Medicine)
Hyun, Myung-Chul (Department of Pediatrics, Kyungpook National University School of Medicine)
Kwon, Tae-Chan (Departments of Pediatrics, Keimyung University School of Medicine)
Lee, Sang-Bum (Department of Pediatrics, Kyungpook National University School of Medicine)
Publication Information
Clinical and Experimental Pediatrics / v.53, no.4, 2010 , pp. 519-524 More about this Journal
Abstract
Purpose : To determine the efficacy of the N-terminal fragment of B-type natriuretic peptide (NT-proBNP) as a useful diagnostic method in children with incomplete Kawasaki disease (KD). Methods : Ninety-six patients who were diagnosed as having KD between January 2008 and June 2009 were enrolled in the study. American Heart Association recommendations for diagnosis were used, and patients were divided into the complete KD and incomplete KD groups. Blood tests including NT-proBNP were performed on admission day. Nineteen patients who had other febrile diseases other than KD were enrolled as control. Results : Thirty-three patients (34%) had incomplete KD. Change in the lips and oral cavity and conjunctivitis were the most common clinical features, but their frequency was lower than complete KD (76% vs 98%, 76% vs 90%). Patients with incomplete KD exhibited significantly higher NT-proBNP level than that of control ($1,407.7{\pm}1633.5pg/mL$ vs $126.2{\pm}135.5pg/mL$, $P$<0.001). An NT-proBNP cutoff value of 158 pg/mL provided a sensitivity of 81% and a specificity of 74% for diagnosis of incomplete KD. Conclusion : NT-proBNP assay can be clinically useful for the diagnosis of incomplete KD, if the patient has persistent fever, change in the lips and oral cavity, and conjunctivitis, and if the patient with those symptoms is suspected to have incomplete KD.
Keywords
Kawasaki disease; NT-proBNP;
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1 Cowie M, Jourdain P, Maisel A, Dahlstrom U, Follath F, Isnard R, et al. Clinical applications of B-type natriuretic peptide(BNP) testing. Eur Heart J 2003;24:1710-8.   DOI   ScienceOn
2 Morita E, Yasue H, Yoshimura M, Ogawa H, Jougasaki M, Matsumura T, et al. Increased plasma levels of brain natriuretic peptide in patients with acute myocardial infarction. Circulation 1993;88:82-91.   DOI   ScienceOn
3 Fried I, Bar-Oz B, Perles Z, Rein AJ, Zonis Z, Nir A. Nterminal Pro-B-type natriuretic peptide levels in acute versus chronic left ventricular dysfunction. J Pediatr 2006;149:28-31.   DOI   ScienceOn
4 Nir A, Lindinger A, Rauh M, Bar-Oz B, Laer S, Schwachtgen L, et al. NT-Pro-B-type natriuretic peptide in infants and children: reference values based on combined data from four studies. Pediatr Cardiol 2009;30:3-8.   DOI   ScienceOn
5 Reynolds EW, Ellington JG, Vranicar M, Bada HS. Brain type natriuretic peptide in the diagnosis and management of persistent pulmonary hypertension of the newborn. Pediatrics 2004;114:1297-304.   DOI   ScienceOn
6 Masson S, Latini R. Amino-terminal pro-B-type natriuretic peptides and prognosis in chronic heart failure. Am J Cardiol 2008;101:56-60.   DOI   ScienceOn
7 Law YM, Ettedgui J, Beerman L, Maisel A, Tofovic S. Comparison of plasma B-type natriuretic peptide levels in single ventricle patients with systemic ventricle heart failure versus isolated cavopulmonary failure. Am J Cardiol 2006;98:520-4.   DOI   ScienceOn
8 Kalra PR, Anker SD, Coats AJ. Water and sodium regulation in chronic heart failure : the role of natriuretic peptides and vasopressin. Cardiovasc Res 2001;51:495-509.   DOI   ScienceOn
9 Nir A, Lindinger A, Rauh M, Bar-Oz B, Laer S, Schwachtgen L, et al. NT-pro-B-type natriuretic peptide in infants and children: reference values based on combined data from four studies. Pediatr Cardiol 2009;30:3-8.   DOI   ScienceOn
10 Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the committee on rheumatic fever, endocarditis, and Kawasaki disease, council on cardiovascular disease in the young, American Heart Association. Pediatrics 2004;114:1708- 33.   DOI   ScienceOn
11 Omland T, Persson A, Ng L, O'Brien R, Karlsson T, Herlitz J, et al. N-terminal pro-B-type natriuretic peptide and longterm mortality in acute coronary syndromes. Circulation 2002; 106:2913-8.   DOI   ScienceOn
12 Bionda C, Bergerot C, Ardail D, Rodriguez-Lafrasse C, Rousson R. Plasma BNP and NT-proBNP assays by automated immunoanalyzers: analytical and clinical study. Ann Clin Lab Sci 2006;36:299–306.
13 Joffe A, Kabani A, Jadavji T. Atypical and complicated Kawasaki disease in infants: do we need criteria? West J Med 1995;162:322-7.
14 Heo MY, Choi SJ, Kim HS, Sohn SJ. Clinical features of aty  pical Kawasaki disease. J Korean Pediatr Soc 2002;45:376-82..
15 Lee HJ, Kim HJ, Kim HS, Sohn SJ. NT-pro BNP: A new diagnostic screening tool for Kawasaki disease. Korean J Pediatr 2006;49:539-44.   DOI
16 Yu YI, Kim DJ, Yum MK, Kim Ns, Lee HB. Clinical study of typical and atypical Kawasaki diseases. J Korean Pediatr Soc 1998;41:237-46.
17 Fukushige J, Takahashi N, Ueda Y, Ueda K. Incidence and clinical features of incomplete Kawasaki disease. Acta Paediatr 1994;83:1057-60.   DOI   ScienceOn
18 Ohuchi H, Takasugi H, Ohashi H, Okada Y, Yamada O, Ono Y, et al. Stratification of pediatric heart failure on the basis of neurohormonal and cardiac autonomic nervous activities in patients with congenital heart disease. Circulation 2003; 108:2368–76.
19 Kawamura T, Wago M, Kawaguchi H, Tahara M, Yuge M. Plasma brain natriuretic peptide concentrations in patients with Kawasaki disease. Pediatr Int 2000;42:241-8.   DOI   ScienceOn
20 Anne HR, Stanford TS. Kawasaki syndrome. Pediatr Clin North Am 1999;46:313-29.   DOI   ScienceOn
21 Suda K, Matsumura M, Matsumoto M. Clinical implication of plasma natriuretic peptides in children with ventricular septal defect. Pediatr Int 2003;45:249–54.   DOI   ScienceOn
22 Cowie M, Mendez G. BNP and congestive heart failure. Prog Cardiovasc Dis 2002;44:293-321.   DOI   ScienceOn
23 Dahdah N, Siles A, Fournier A, Cousineau J, Delvin E, Saint- Cyr C, et al. Natriuretic peptide as an adjunctive diagnostic test in the acute phase of Kawasaki disease. Pediatr Cardiol 2009;30:810-7.   DOI   ScienceOn
24 Uusimaa P, Ruskoaho H, Vuolteenaho O, Niemelä M, Lumme J, Ikäheimo M, et al. Plasma vasoactive peptides after acute myocardial infarction in relation to left ventricular dysfunction. Int J Cardiol 1999;69:5–14.   DOI   ScienceOn
25 Saenger AK, Jaffe AS. The use of biomarkers for the evaluation and treatment of patients with acute coronary syndromes. Med Clin North Am 2007;91:657-81.   DOI   ScienceOn
26 Mukoyama M, Nakao K, Saito Y, Ogawa Y, Hosoda K, Suga S, et al. Increased human brain natriuretic peptide in congestive heart failure. N Engl J Med 1990;323:757-8.   DOI   ScienceOn
27 Price JF, Thomas AK, Grenier M, Eidem BW, O'Brian Smith E, Denfield SW. et al. B-type natriuretic peptide predicts adverse cardiovascular events in pediatric outpatients with chronic left ventricular systolic dysfunction. Circulation 2006; 114:1063–9.   DOI   ScienceOn