Usefulness of age-adjusted N-terminal prohormone of brain natriuretic peptide level as a diagnostic marker for incomplete Kawasaki disease in children
- PMID: 30963739
Usefulness of age-adjusted N-terminal prohormone of brain natriuretic peptide level as a diagnostic marker for incomplete Kawasaki disease in children
Abstract
Objectives: The main objective was to assess the diagnostic usefulness of age-adjusted level of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) as a diagnostic marker in children suspected of having incomplete Kawasaki disease (IKD). The secondary aim was to compare the diagnostic yield of NT-proBNP level with the yield of other markers currently recommended by the American Heart Association (AHA).
Material and methods: Descriptive cross-sectional study of a case series of patients under the age of 14 years admitted with clinical suspicion of IKD between 2013 and 2017. We analyzed NT-proBNP level adjusted for age. Demographic, clinical, echocardiographic, analytic, and microbiologic findings were gathered from computerized charts. Two independent evaluators made the diagnosis of IKD according to AHA criteria.
Results: We included 70 cases, and 19 (27%) were diagnosed with IKD. Patients with IKD had higher NT-proBNP levels than patients with other febrile diseases, and the proportion of cases of elevated age-adjusted NT-proBNP level was also higher in the IKD group (84% vs 4%; P<.001). The diagnostic yield of age-adjusted NT-proBNP for IKD was good (area under the receiver operating characteristic curve, 0.90; 95% CI, 0.80-0.99) and significantly higher than the yields for C-reactive protein, erythrocyte sedimentation rate, albumin, and sterile pyuria (P<.001, all comparisons).
Conclusion: NT-proBNP level may prove to be a valid diagnostic marker for IKD, possibly offering a higher diagnostic yield than the analyses currently recommended for children suspected of having IKD.
Objetivo: Evaluar la validez diagnóstica del NT-proBNP ajustado por la edad para enfermedad de Kawasaki incompleta (EKI) en pacientes pediátricos con sospecha clínica de EKI y comparar su capacidad diagnóstica con los parámetros analíticos diagnósticos recomendados actualmente por la American Heart Association (AHA).
Metodo: Se incluyó a todos los pacientes menores de 14 años ingresados por sospecha de EKI desde 2013 hasta 2017. Se registró el valor de NT-proBNP ajustado por la edad, datos demográficos, clínicos, analíticos, ecocardiográficos y microbiológicos. El diagnóstico de EKI lo realizaron dos evaluadores según los criterios de la AHA.
Resultados: Se incluyeron 70 pacientes: 19 (27%) fueron clasificados como EKI, y presentaron mayores concentraciones de NT-proBNP (p < 0,001), y un mayor porcentaje de casos de NT-proBNP elevado para la edad (84% vs 4%; p < 0,001) en comparación con otras enfermedades febriles. El NT-proBNP ajustado por la edad tuvo una buena capacidad diagnóstica para la EKI (área bajo la curva = 0,90; IC95% 0,80-0,99), superior a la proteína C reactiva (p < 0,001), velocidad globular de sedimentación (p < 0,001), albúmina (p < 0,001) y piuria estéril (p < 0,001).
Conclusiones: El NT-proBNP podría ser un test diagnóstico válido para la EKI y potencialmente superior a los parámetros analíticos actualmente recomendados en los pacientes pediátricos con sospecha de EKI.
Keywords: NT-proBNP; Pediatrics; Biological markers; Biomarcadores; Enfermedad de Kawasaki; Kawasaki disease; NT-proBNP; Pediatría.
Comment in
-
On the usefulness of N-terminal prohormone of brain natriuretic peptide for the diagnosis of incomplete Kawasaki disease.Emergencias. 2019 Oct;31(5):366-367. Emergencias. 2019. PMID: 31625316 English, Spanish. No abstract available.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials
