• The Journal of pediatrics · Jun 2013

    Clinical Trial

    N-terminal pro-brain natriuretic peptide and risk of coronary artery lesions and resistance to intravenous immunoglobulin in Kawasaki disease.

    • Ken Yoshimura, Takahisa Kimata, Kenji Mine, Takamichi Uchiyama, Shoji Tsuji, and Kazunari Kaneko.
    • Department of Pediatrics, Kansai Medical University, Osaka, Japan. yoshimuk@hirakata.kmu.ac.jp
    • J. Pediatr. 2013 Jun 1; 162 (6): 1205-9.

    ObjectiveTo determine whether the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) can be a useful marker not only to identify the patients with Kawasaki disease (KD) who are at a higher risk of developing coronary artery lesions (CAL), and predict resistance to intravenous immunoglobulin (IVIG).Study DesignWe enrolled 80 patients with the acute phase of KD at a single center. The demographic, clinical, and laboratory data were prospectively collected.ResultsNineteen of the 80 patients developed CAL, despite IVIG administration. They had a significantly higher serum NT-proBNP level in comparison with the patients without CAL. The NT-proBNP cut-off value of 1300 pg/mL yielded a sensitivity of 95% and a specificity of 85% for predicting CAL. However, 17 of the 80 patients were IVIG non-responders. They also had a significantly higher serum NT-proBNP level in comparison with the IVIG responders. The NT-proBNP cut-off value of 800 pg/mL yielded a sensitivity of 71% and a specificity of 62% for predicting IVIG non-responders.ConclusionsThe serum NT-proBNP level is increased in children with KD with CAL and IVIG resistance. It may be useful to predict CAL and IVIG resistance in KD.Crown Copyright © 2013. Published by Mosby, Inc. All rights reserved.

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