title: N-terminal pro-brain natriuretic Peptide as a useful diagnostic marker of acute Kawasaki disease in children.
abstract: BACKGROUND
  Serum N-terminal pro-brain natriuretic peptide (NTproBNP) is often elevated in patients with acute Kawasaki disease (KD), but the NTproBNP level in normal children is higher than in adults. Thus, characterization of the normal levels and cut-off values of NTproBNP according to age is warranted for proper diagnosis of acute KD in children.
  
  
  RESULTS
  Six hundred and fifty-five patients aged 1 month-15 years (median, 2.9 years) were included. Patients were admitted to the NTT East Japan Sapporo Hospital between October 2007 and October 2011. Serum NTproBNP level was examined in 149 patients with KD (median, 2.1 years) and 506 control patients with acute infectious disease (median, 3.2 years). In the control group, a Z-score curve of NTproBNP was generated for each age group using least mean square-based methods. The Z-score distribution of KD patients was then compared with that of the control group. The specificity and sensitivity of NTproBNP for diagnosing acute KD were 97.8% and 47.0%, respectively, at Z-score >2.0. Additionally, simple cut-offs every 100 pg/ml according to age were established for more convenient use at the bedside.
  
  
  CONCLUSIONS
  The Z-score curve for NTproBNP in children was characterized. A Z-score >2.0 or the cut-off for children may be used to diagnose acute KD.
authors.affiliation: Department of Pediatrics, NTT East Japan Sapporo Hospital, Sapporo, Japan. shira_p_0420@yahoo.co.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shiraishi
authors.forename: Shigeto
authors.initials: S
authors.lastname: Fuse
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mori
authors.forename: Atsushi
authors.initials: A
authors.lastname: Doyama
authors.forename: Saho
authors.initials: S
authors.lastname: Honjyo
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hoshino
authors.forename: Emiko
authors.initials: E
authors.lastname: Hoshino
authors.forename: Azusa
authors.initials: A
authors.lastname: Kawaguchi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kuroiwa
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Hotsubo
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; 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*; D012189:Retrospective Studies
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain