N-terminal Pro-Brain Natriuretic Peptide, Adjuvant Laboratory Marker of Acute Phase of Kawasaki Disease in Emergency Department

摘要

Purpose: Diagnosis of Kawasaki disease (KD) in emergency department (ED) is sometimes difficult because of unsatisfied diagnostic criteria, especially when febrile days are less than 5 days. Clinical and laboratory features may be helpful in establishing the diagnosis in these cases. N-terminal pro-brain natriuretic peptide (NT-proBNP) has been proved as a laboratory indicator for identifying patients with KD, but usefulness in ED has not been studied. Methods: NT-proBNP levels obtained from patients who were suspected as KD at present in ED, from January 1, 2011 to December 31, 2013. The patients were divided into KD with less than 5 febrile days and other febrile disease group according to final diagnosis. The difference of each group, thesensitivity and specificity of NT-proBNP value were analyzed. Results: In the group of less than 5 febrile days, NT-proBNP levels were significantly higher in the KD patients (P=0.01). In the receiver operating characteristic curve analysis in the group of less than 5 febrile days, the sensitivity was 62.5, and the specificity was 77.7 at 105.5 pg/mL of NT-proBNP level. Conclusion: We expect that NT-proBNP would be a useful adjuvant diagnostic tool for KD patients with atypical clinical presentations, especially in cases with less than 5 febrile days.