N-terminal pro-B-type natriuretic peptide diagnostic algorithm versus American Heart Association algorithm for Kawasaki disease.
Pediatr Int
; 59(3): 265-270, 2017 Mar.
Article
in En
| MEDLINE
| ID: mdl-27589358
ABSTRACT
BACKGROUND:
Diagnosis of Kawasaki disease (KD) can be challenging in the absence of a confirmatory test or pathognomonic finding, especially when clinical criteria are incomplete. We recently proposed serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) as an adjunctive diagnostic test.METHODS:
We retrospectively tested a new algorithm to help KD diagnosis based on NT-proBNP, coronary artery dilation (CAD) at onset, and abnormal serum albumin or C-reactive protein (CRP). The goal was to assess the performance of the algorithm and compare its performance with that of the 2004 American Heart Association (AHA)/American Academy of Pediatrics (AAP) algorithm.RESULTS:
The algorithm was tested on 124 KD patients with NT-proBNP measured on admission at the present institutions between 2007 and 2013. Age at diagnosis was 3.4 ± 3.0 years, with a median of five diagnostic criteria; and 55 of the 124 patients (44%) had incomplete KD. CA complications occurred in 64 (52%), with aneurysm in 14 (11%). Using this algorithm, 120/124 (97%) were to be treated, based on high NT-proBNP alone for 79 (64%); on onset CAD for 14 (11%); and on high CRP or low albumin for 27 (22%). Using the AHA/AAP algorithm, 22/47 (47%) of the eligible patients with incomplete KD would not have been referred for treatment, compared with 3/55 (5%) with the NT-proBNP algorithm (P < 0.001).CONCLUSION:
This NT-proBNP-based algorithm is efficient to identify and treat patients with KD, including those with incomplete KD. This study paves the way for a prospective validation trial of the algorithm.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Peptide Fragments
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Algorithms
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Decision Support Techniques
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Natriuretic Peptide, Brain
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Clinical Decision-Making
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Mucocutaneous Lymph Node Syndrome
Type of study:
Diagnostic_studies
/
Evaluation_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
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Child
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Child, preschool
/
Female
/
Humans
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Infant
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Male
/
Newborn
Country/Region as subject:
America do norte
Language:
En
Journal:
Pediatr Int
Journal subject:
PEDIATRIA
Year:
2017
Document type:
Article
Affiliation country: