Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Clinical characteristics and serum N-terminal pro-brain natriuretic peptide as a diagnostic marker of Kawasaki disease in infants younger than 3 months of age

  • Bae, Hyun Kyung (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Lee, Do Kyung (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Kwon, Jung Hyun (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Kim, Hae Soon (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Sohn, Sejung (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Hong, Young Mi (Department of Pediatrics, Ewha Womans University School of Medicine)
  • 투고 : 2013.11.25
  • 심사 : 2014.03.05
  • 발행 : 2014.08.10
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초록

Purpose: The incidence of Kawasaki disease (KD) is rare in young infants (less than 3 months of age), who present with only a few symptoms that fulfill the clinical diagnostic criteria. The diagnosis for KD can therefore be delayed, leading to a high risk of cardiac complications. We examined the clinical characteristics and measured the serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels of these patients for assessing its value in the early detection of KD. Methods: We retrospectively reviewed the data of young infants diagnosed with KD from 2004 to 2012. The control group included 20 hospitalized febrile patients. Laboratory data, including NT-proBNP were obtained for each patient in both groups. Results: Incomplete KD was observed in 21/24 patients (87.5%). The mean fever duration on admission was $1.36{\pm}1.0$ days in the KD group. Common symptoms included erythema at the site of Bacille Calmette-Guerin inoculation (70.8%), skin rash (50.0%), changes of oropharyngeal mucosa (29.1%), and cervical lymphadenopathy (20.8%). The mean number of major diagnostic criteria fulfilled was $2.8{\pm}1.4$. Five KD patients (20.8%) had only one symptom matching these criteria. The incidence of coronary artery complications was 12.5%. The mean serum NT-proBNP level in the acute phase, in the KD and control groups, were $4,159{\pm}3,714pg/mL$ and $957{\pm}902pg/mL$, respectively, which decreased significantly in the convalescent phase. Conclusion: Incomplete KD was observed in 87.5% patients. Serum NT- proBNP might be a valuable biomarker for the early detection of KD in febrile infants aged <3 months.

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참고문헌

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피인용 문헌

  1. Cardiac Function in Kawasaki Disease Patients with Respiratory Symptoms vol.45, pp.4, 2014, https://doi.org/10.4070/kcj.2015.45.4.317
  2. Kawasaki Disease with Optic Disc Swelling and Uveitis vol.39, pp.4, 2014, https://doi.org/10.12771/emj.2016.39.4.133
  3. Adjunct cyclosporine therapy for refractory Kawasaki disease in a very young infant vol.58, pp.4, 2014, https://doi.org/10.1111/ped.12778
  4. Differentiation between incomplete Kawasaki disease and secondary hemophagocytic lym­phohistiocytosis following Kawasaki disease using N­-terminal pro­-brain natriuretic peptide vol.61, pp.5, 2014, https://doi.org/10.3345/kjp.2018.61.5.167
  5. Kawasaki disease in infants 3 months of age and younger: a multicentre Spanish study vol.78, pp.2, 2014, https://doi.org/10.1136/annrheumdis-2018-213891
  6. N-terminal probrain natriuretic peptide as biomarker for diagnosis of Kawasaki disease vol.13, pp.4, 2014, https://doi.org/10.2217/bmm-2018-0324
  7. Diagnostic accuracy of N‐terminal pro‐brain natriuretic peptide for Kawasaki disease: An updated systematic review and meta‐analysis vol.75, pp.11, 2014, https://doi.org/10.1111/ijcp.14538