title: Value of amino-terminal pro B-natriuretic peptide in diagnosing Kawasaki disease.
abstract: BACKGROUND
  The aim of the present study was to investigate the diagnostic value of the N-terminal B-type natriuretic peptide (NT-proBNP) in acute Kawasaki disease (KD) given that the clinical criteria and the current basic laboratory tests lack the necessary specificity for accurate diagnosis.
  
  
  METHODS
  Basic biological tests and serum NT-proBNP levels obtained from acute KD patients were compared to that of febrile controls. NT-proBNP was considered abnormal based on the following definitions: above a cut-off determined on receiver operator characteristic (ROC) analysis, above the upper limit for age, or above 2 SD calculated from healthy children. Analyses were also performed for KD cases with complete or incomplete criteria combined and separately.
  
  
  RESULTS
  There were 81 patients and 49 controls aged 3.60 ± 2.77 versus 4.25 ± 3.88 years (P= 0.69). ROC analysis yielded significant area under the curve for NT-proBNP. The sensitivity, specificity, positive and negative predictive values were 70.4-88.9%, 69.4-91.8%, 82.8-93.4%, and 65.2-79.1%. The odds ratios based on NT-proBNP definitions varied between 18.13 (95% confidence interval [CI]: 7.21-45.57), 20.82 (95%CI: 8.18-53.0), and 26.71 (95%CI: 8.64-82.57; P < 0.001). Results were reproducible for cases with complete or incomplete criteria separately.
  
  
  CONCLUSIONS
  NT-proBNP is a reliable marker for the diagnosis of KD. Prospective clinical studies with emphasis on NT-proBNP in a diagnostic algorithm are needed.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Quebec, Canada.
authors.forename: Ariane
authors.initials: A
authors.lastname: McNeal-Davidson
authors.forename: Anne
authors.initials: A
authors.lastname: Fournier
authors.forename: Linda
authors.initials: L
authors.lastname: Spigelblatt
authors.forename: Claire
authors.initials: C
authors.lastname: Saint-Cyr
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Mir
authors.forename: Amiram
authors.initials: A
authors.lastname: Nir
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dallaire
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Cousineau
authors.forename: Edgard
authors.initials: E
authors.lastname: Delvin
authors.forename: Nagib
authors.initials: N
authors.lastname: Dahdah
mesh_terms: D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000175:diagnosis*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain