title: Adjuvant laboratory marker of Kawasaki disease; NT-pro-BNP or hs-CRP?
abstract: BACKGROUND
  The diagnosis of Kawasaki disease (KD) is based on clinical data and non-pathognomonic symptoms. As no specific diagnostic test for KD exists, BNP or NT-pro-BNP might be of importance in identifying KD. We compared serum hs-CRP and NT-pro-BNP level in the acute phase of 59 KD patients and evaluated the diagnostic performance of these laboratory markers in KD to estimate the cut-off level for differentiating KD from other febrile illnesses as age-matched controls.
  
  
  METHODS
  The study groups consisted of 59 KD patients in the disease group and 45 other patients with febrile illnesses as age-matched controls. NT-pro-BNP was measured using Elecsys proBNP (Roche Diagnostics, Mannheim, Germany), and hs-CRP was tested with CardioPhase hs-CRP (Siemens Healthcare Diagnostics, Marburg, Germany).
  
  
  RESULTS
  NT-pro-BNP levels were significantly higher in the KD patients than in the controls (P < 0.001). In the ROC curve analysis, the sensitivity was 66.10%, and the specificity was 77.08% at 235.2 pg/mL. hs-CRP levels tended to be higher in KD patients compared to controls.
  
  
  CONCLUSIONS
  This study indicates that NT-pro-BNP might be a more useful laboratory marker as an adjuvant diagnostic tool for KD than hs-CRP. Especially in a patient with incomplete clinical features of KD, the diagnosis and the start of treatment were delayed to confirm a fever persisting for at least 5 days. Therefore, we expect that NT-pro- BNP would be especially useful for KD patients with these atypical clinical presentations.
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Kyung Hee University,1 Hoegidong, Dongdaemun-gu, Seoul 130-702, Korea.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Cho
authors.forename: Yeongsic
authors.initials: Y
authors.lastname: Kim
authors.forename: Sung-Ho
authors.initials: SH
authors.lastname: Cha
authors.forename: Jin-Tae
authors.initials: JT
authors.lastname: Suh
authors.forename: Mi Young
authors.initials: MY
authors.lastname: Han
authors.forename: Hee Joo
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012372:ROC Curve
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein