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NT-proBNP as a useful tool in diagnosing incomplete Kawasaki disease

Korean Journal of Pediatrics 2010;53(4):519-524.
Published online April 15, 2010.
NT-proBNP as a useful tool in diagnosing incomplete Kawasaki disease
Dong Won Lee1, Yeo Hyang Kim2, Myung Chul Hyun1, Tae Chan Kwon2, Sang Bum Lee1
1Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
2Departments of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
불완전 가와사끼병에서 NT-proBNP의 진단적 역할
이동원1, 김여향2, 현명철1, 권태찬2, 이상범1
1경북대학교 의학전문대학 소아과학교실
2계명대학교 의과대학 소아과학교실
Correspondence: 
Yeo Hyang Kim, Email: kimyhped@hanmail.net
Abstract
Purpose
: To determine the efficacy of the N-terminal fragment of B-type natriuretic peptide (NT-proBNP) as a useful diagnostic method in children with incomplete Kawasaki disease (KD).
Methods
: Ninety-six patients who were diagnosed as having KD between January 2008 and June 2009 were enrolled in the study. American Heart Association recommendations for diagnosis were used, and patients were divided into the complete KD and incomplete KD groups. Blood tests including NT-proBNP were performed on admission day. Nineteen patients who had other febrile diseases other than KD were enrolled as control.
Results
: Thirty-three patients (34%) had incomplete KD. Change in the lips and oral cavity and conjunctivitis were the most common clinical features, but their frequency was lower than complete KD (76% vs 98%, 76% vs 90%). Patients with incomplete KD exhibited significantly higher NT-proBNP level than that of control (1,407.7¡¾1633.5 pg/mL vs 126.2¡¾135.5 pg/mL, P <0.001). An NT-proBNP cutoff value of 158 pg/mL provided a sensitivity of 81% and a specificity of 74% for diagnosis of incomplete KD.
Conclusion
: NT-proBNP assay can be clinically useful for the diagnosis of incomplete KD, if the patient has persistent fever, change in the lips and oral cavity, and conjunctivitis, and if the patient with those symptoms is suspected to have incomplete KD.
Key Words: Kawasaki disease, NT-proBNP


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