title: N-terminal pro-brain natriuretic peptide levels associated with severe hand, foot and mouth disease.
abstract: Severe hand, foot, and mouth disease (HFMD) is sometimes associated with serious complications such as acute heart failure that can cause substantial child mortality. N-terminal pro-brain natriuretic peptide (NT-proBNP) is a sensitive and specific biomarker of congestive heart failure. The aim of this study was to use plasma NT-proBNP levels to establish the severity of childhood HFMD.
  
  
  
  A retrospective study was performed in 128 Chinese patients with severe HFMD and 88 patients with mild HFMD treated between January 2014 and October 2015. Univariate and multiple logistic regression analyses were used to analyze the risk factors for severe HFMD. NT-proBNP levels were analyzed in 128 severe HFMD patients, and the predictive value of NT-proBNP was assessed by receiver operating characteristic analyses.
  
  
  
  Multivariate analysis controlling for several potential confounders showed that enterovirus 71 infection [odds ratio (OR) 19.944, 95 % confidence interval (CI) 6.492-61.271], peripheral WBC count (OR 3.428, 95 % CI 1.186-9.914), fasting glucose (OR 19.428, 95 % CI 2.236-168.784), procalcitonin (OR 9.084, 95 % CI 3.462-23.837, and NT-proBNP (>125 pg/mL) (OR 16.649, 95 % CI 4.731-58.585) were each associated with the severity of HFMD. The 45 dead severe patients had higher pre-procedural levels of NT-proBNP than the 83 cured severe patients (12776 ± 13115 versus 1435 ± 4201 pg/mL, P < 0.001). An NT-proBNP cutoff value of 982 pg/mL predicted mortality with 87 % sensitivity and 86 % specificity.
  
  
  
  Plasma NT-pro-BNP level appears to be a useful biological marker for predicting the severity and mortality of HFMD.
authors.affiliation: Department of Infectious Diseases, Second Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, 710004, China.|Department of Infectious Diseases, Xi'an Children's Hospital, Xi'an, 710003, China.
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Deng
authors.affiliation: Department of Infectious Diseases, Xi'an Children's Hospital, Xi'an, 710003, China.
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Zhang
authors.affiliation: Department of Infectious Diseases, Second Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, 710004, China.
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: Li
authors.affiliation: Department of Infectious Diseases, Xi'an Children's Hospital, Xi'an, 710003, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Infectious Diseases, Xi'an Children's Hospital, Xi'an, 710003, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Infectious Diseases, Xi'an Children's Hospital, Xi'an, 710003, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Infectious Diseases, Xi'an Children's Hospital, Xi'an, 710003, China.
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Wang
authors.affiliation: Department of Infectious Diseases, Second Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, 710004, China. dang212@126.com.
authors.forename: Shuang-Suo
authors.initials: SS
authors.lastname: Dang
mesh_terms: D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000097:blood* / Q000209:etiology / Q000401:mortality; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D016017:Odds Ratio; D010446:Peptide Fragments / Q000097:blood*; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Disease severity; Hand, foot, and mouth disease; Mortality; N-terminal pro-brain natriuretic peptide