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. 2019 Nov 27;9(1):17641.
doi: 10.1038/s41598-019-54113-1.

Changes in and significance of platelet function and parameters in Kawasaki disease

Xiaolan Zheng  1   2   3 , Wenchao Wu  4 , Yi Zhang  5   6 , Gang Wu  7   8
Affiliations

Changes in and significance of platelet function and parameters in Kawasaki disease

Xiaolan Zheng et al. Sci Rep. .

Abstract

Kawasaki disease (KD) is a systemic febrile, inflammatory vascular disease of unknown etiology. The coronary artery abnormality (CAA) caused by KD has become the most commonly acquired heart disease in children. Initial treatment of intravenous immunoglobulin (IVIG) can reduce the incidence of CAA. Thrombocytosis is common during the course of KD, but changes in and significances of platelet function and parameters are unclear. In this study, we enrolled 120 patients, including 40 patients with KD, 40 febrile controls, and 40 afebrile controls. The platelet function was assessed using the platelet function analyzer (PFA)-200. Platelet parameters, including platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and platelet hematocrit (PCT) were measured. In the febrile period, the PDW and MPV were lower in KD patients (P < 0.05). The platelet function did not change significantly during the febrile period of KD but weakened in the defervescence phase. No significant differences between the CAA and normal groups, and between IVIG resistance and response groups. The diagnostic cutoff value of the PDW level for predicting KD was 10.85 fL with a sensitivity of 55% and a specificity of 77.5% (area under curve (AUC) = 0.690, 95% confidence interval (CI): 0.574-0.806, P < 0.01). Besides, the MPV level was 9.55 fL with sensitivity of 75% and specificity of 70% (AUC = 0.733, 95%CI: 0.620-0.846, P < 0.001). This is the first longitudinal study of platelet function changes in KD patients using PFA-200. Besides, lower PDW and MPV may be available markers for early diagnosis of KD.

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Conflict of interest statement

The authors report no conflict of interest. The authors are responsible for the content and writing of the paper.

Figures

Figure 1
Figure 1
Comparison of platelet function and parameters between the KD group and the febrile control group. (A) Comparison of EPI between two groups. (B) Comparison of ADP between two groups. (C) Comparison of PLT between two groups. (D) Comparison of PDW between two groups. (E) Comparison of MPV between two groups. (F) Comparison of PCT between two groups.
Figure 2
Figure 2
Comparison of platelet function and parameters between the KD group and the afebrile control group. (A) Comparison of EPI between two groups. (B) Comparison of ADP between two groups. (C) Comparison of PLT between two groups. (D) Comparison of PDW between two groups. (E) Comparison of MPV between two groups. (F) Comparison of PCT between two groups.
Figure 3
Figure 3
ROC curves of PDW and MPV in the prediction of KD.
See this image and copyright information in PMC

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