title: N-terminal pro-brain natriuretic peptide can be an adjunctive diagnostic marker of hyper-acute phase of Kawasaki disease.
abstract: The purpose of this study was to determine whether the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level could be a useful marker for Kawasaki disease in the pediatric emergency department (PED) and in the presence of fever duration of 4 days or less (hyper-acute phase of Kawasaki disease). Medical records of patients who were 1 month to 15 years old of age and presented at the PED with suspected Kawasaki disease from January 1, 2010, to December 31, 2014, were collected retrospectively. Two hundred thirty-nine patients with a history of fever for 4 days or less were diagnosed with Kawasaki disease, as well as 111 patients with other febrile diseases, and were enrolled. The NT-proBNP level was significantly higher in patients with Kawasaki disease (Kawasaki disease vs. other febrile disease group, 444.8 (189.7-951.5) vs. 153.4 (68.9-287.6) pg/mL; p < 0.001), and a cutoff value of 244.7 pg/mL yielded a sensitivity and specificity of 68.6 and 70.3 %, respectively. The area under the curve of the NT-proBNP for predicting Kawasaki disease was 0.763 (95 % CI 0.712-0.814).
  
  
  CONCLUSIONS
  NT-proBNP might be an adjunctive laboratory marker for hyper-acute phase of Kawasaki disease in the PED. What is Known: • N-terminal pro-brain natriuretic peptide level has been reported as a useful marker for diagnosis in patients with the acute phase of Kawasaki disease. • But, in the cases of less than 5 days of fever, the appropriate level of NT-proBNP for differentiating Kawasaki disease in PED has not been yet evaluated. What is New: • NT-proBNP might be an adjunctive laboratory marker for hyper-acute phase of Kawasaki disease.
authors: Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors: Hyuksool
authors: H
authors: Kwon
authors: Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
authors: Jin Hee
authors: JH
authors: Lee
authors: Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors: Jae Yun
authors: JY
authors: Jung
authors: Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea. yhkwak@snuh.org.|Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea. yhkwak@snuh.org.
authors: Young Ho
authors: YH
authors: Kwak
authors: Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
authors: Do Kyun
authors: DK
authors: Kim
authors: Department of Emergency Medicine, Seoul National University Boramae Hospital, Seoul, Republic of Korea.
authors: Jin Hee
authors: JH
authors: Jung
authors: Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
authors: Ikwan
authors: I
authors: Chang
authors: Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors: Kyuseok
authors: K
authors: Kim
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever / Q000209:etiology; 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*; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Diagnostic marker; Fever; Kawasaki disease; N-terminal pro-brain natriuretic peptide