title: Procalcitonin (PCT) and Kawasaki Disease: Does PCT Correlate With IVIG-Resistant Disease, Admission to the Intensive Care Unit, or Development of Coronary Artery Lesions?
abstract: BACKGROUND
  Kawasaki disease (KD) remains a clinical diagnosis due to the absence of a sensitive and specific diagnostic test. There are limited published data on the usefulness of procalcitonin (PCT) as a biomarker for the diagnosis or prognosis of children with KD. We hypothesized that PCT might be useful in predicting coronary artery lesions (CALs) and intravenous immunoglobulin (IVIG) resistance.
  
  
  METHODS
  Eighty-five children with KD who were hospitalized within the first 10 days of illness were retrospectively reviewed. PCT was measured on stored serum or plasma samples obtained at the time of admission (pre-IVIG). Data were analyzed to determine whether there were statistically significant associations with PCT, erythrocyte sedimentation rate, and C-reactive protein levels and the incidence of CALs, pediatric intensive care unit admission, or IVIG-resistant disease in KD patients.
  
  
  RESULTS
  PCT values in children hospitalized with acute KD ranged from 0.1 ng/mL to 143.9 ng/mL, with a median of 0.49 ng/mL (IQR 0.23-1.29 ng/mL). There was no correlation of PCT with patient age, race, or sex, but it was correlated with day of illness. KD patients with a PCT ≥ 0.5 ng/mL had a significantly higher incidence of IVIG-resistant disease (29% versus 7%, P = .02). There was no association between PCT and development of CALs in our sample.
  
  
  CONCLUSIONS
  Additional research is needed to establish the sensitivity and specificity of PCT for the diagnosis of KD. PCT may be of value in predicting which children are at increased risk for IVIG-resistant disease.
authors.affiliation: Department of Pediatrics, Section of Infectious Diseases.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Dominguez
authors.affiliation: Department of Pediatrics, Section of Infectious Diseases.
authors.forename: Blake
authors.initials: B
authors.lastname: Martin
authors.affiliation: Department of Pediatrics, Section of Infectious Diseases.
authors.forename: Heather
authors.initials: H
authors.lastname: Heizer
authors.affiliation: Department of Pediatrics, Section of Cardiology.
authors.forename: Pei-Ni
authors.initials: PN
authors.lastname: Jone
authors.affiliation: Department of Pediatrics, Section of Biostatistics, University of Colorado Denver School of Medicine and Children's Hospital Colorado, Aurora.
authors.forename: Suhong
authors.initials: S
authors.lastname: Tong
authors.affiliation: Department of Pediatrics, Section of Cardiology.
authors.forename: Jesse
authors.initials: J
authors.lastname: Davidson
authors.affiliation: Department of Pediatrics, Section of Infectious Diseases.
authors.forename: Marsha S
authors.initials: MS
authors.lastname: Anderson
authors.affiliation: Department of Pediatrics, Section of Infectious Diseases.
authors.forename: Mary P
authors.initials: MP
authors.lastname: Glodé
mesh_terms: D015415:Biomarkers; D002116:Calcitonin / Q000097:blood*; D002648:Child; D003324:Coronary Artery Disease; D006801:Humans; D016756:Immunoglobulins, Intravenous; D007362:Intensive Care Units; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000276:immunology; D011379:Prognosis
chemical_list: D015415:Biomarkers; D016756:Immunoglobulins, Intravenous; D002116:Calcitonin
keywords: C-reactive protein; Kawasaki disease; albumin; biomarkers; procalcitonin