Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Clinical usefulness of serum procalcitonin level in distinguishing between Kawasaki disease and other infections in febrile children

  • Lee, Na Hyun (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Choi, Hee Joung (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Kim, Yeo Hyang (Department of Pediatrics, Kyungpook National University School of Medicine)
  • 투고 : 2016.08.26
  • 심사 : 2016.10.31
  • 발행 : 2017.04.15
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초록

Purpose: The aims of this study were to compare serum procalcitonin (PCT) levels between febrile children with Kawasaki disease (KD) and those with bacterial or viral infections, and assess the clinical usefulness of PCT level in predicting KD. Methods: Serum PCT levels were examined in febrile pediatric patients admitted between August 2013 and August 2014. The patients were divided into 3 groups as follows: 49 with KD, 111 with viral infections, and 24 with bacterial infections. Results: The mean PCT level in the KD group was significantly lower than that in the bacterial infection group ($0.82{\pm}1.73ng/mL$ vs. $3.11{\pm}6.10ng/mL$, P=0.002) and insignificantly different from that in the viral infection group ($0.23{\pm}0.34ng/mL$, P=0.457). The mean erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level in the KD group were significantly higher than those in the viral and bacterial infection groups (P<0.001 and P<0.001 for ESR, P<0.001 and P=0.005 for CRP, respectively). The proportion of patients in the KD group with PCT levels of >1.0 ng/mL was significantly higher in the nonresponders to the initial intravenous immunoglobulin treatment than in the responders (36% vs. 8%, P=0.01). Conclusion: PCT levels may help to differentiate KD from bacterial infections. A combination of disease markers, including ESR, CRP, and PCT, may be useful for differentiating between KD and viral/bacterial infections.

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참고문헌

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피인용 문헌

  1. Kawasaki Disease: The Role of Immune Complexes Revisited vol.10, pp.None, 2017, https://doi.org/10.3389/fimmu.2019.01156
  2. Biomarkers for Kawasaki Disease: Clinical Utility and the Challenges Ahead vol.7, pp.None, 2019, https://doi.org/10.3389/fped.2019.00242
  3. Predictive value of serum procalcitonin for both initial and repeated immunoglobulin resistance in Kawasaki disease: a prospective cohort study vol.17, pp.1, 2017, https://doi.org/10.1186/s12969-019-0379-5
  4. Coronary artery vasculitis: a review of current literature vol.21, pp.1, 2017, https://doi.org/10.1186/s12872-020-01813-6