Delta-neutrophil index: a potential predictor of coronary artery involvement in Kawasaki disease by retrospective analysis

Ko, Kyung Ok; Lim, Jae Woo; Yoon, Jung Min; Song, Young Wha; Lee, Jong Wook; Cheon, Eun Jung

doi:10.1007/s00296-019-04448-9

Cited by 4 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…DNI is a simple test that can be quantitatively measured in routine complete blood counts. It has a diagnostic value in diseases such as pediatric sepsis, meningitis, appendicitis, urinary tract infection, and KD; it has even been also reported to be an important marker in determining morbidity and mortality in these diseases [ 13 – 16 ]. Park et al emphasized that DNI is a potentially useful diagnostic tool in infected patients and should be used more widely in clinical practice to predict mortality [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Delta neutrophil index and C-reactive protein: a potential diagnostic marker of multisystem inflammatory syndrome in children (MIS-C) with COVID-19

et al. 2021

View full text Add to dashboard Cite

Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening hyperinflammation syndrome emerging after COVID-19. The serum delta neutrophil index (DNI) reflects the fraction of circulating immature granulocytes and is evaluated in infection and inflammation. The aim of this study is to evaluate the usefulness of DNI as a diagnostic marker in patients with MIS-C and to assess its role in determining the severity of MIS-C. This retrospective, observational study included 83 patients with MIS-C and 113 patients with COVID-19, and 102 healthy controls. C-reactive protein (CRP), the absolute neutrophil count (ANC), absolute lymphocyte count (ALC), DNI, and the platelet count were recorded. The DNI levels were 4.60 ± 5.70% in the MIS C group, 0.30 ± 0.99% in the COVID group, and 0.20 ± 0.56% in the control group ( p < 0.001). According to the severity of MIS-C, the DNI level was found to be 1.22% in mild MIS-C, 4.3% in moderate MIS-C, and 5.7% in severe MIS-C. There was a statistically significant correlation between DNI levels and the severity of MIS-C. The cutoff value of DNI for predicting MIS-C was 0.45%. In the analysis of the diagnostic performance of DNI compared with CRP, ANC, ALC and platelet counts, sensitivity, specificity, positive predictive value, and negative predictive value were found to be 79.5%, 97.1%, 95.7%, and 85.3%, respectively. Conclusions : The delta neutrophil index was identified as a diagnostic marker for MIS-C such as ANC, ALC, platelet count, and CRP. DNI levels in hemogram analysis may guide clinicians in determining the diagnosis and severity of MIS-C. What is Known: • Although CRP, sedimentation, ALC, ANC, platelet count, sodium, and albumin are used as first step tests, there is no specific laboratory marker used in the diagnosis of MIS C. • The serum delta neutrophil index (DNI) reflects the fraction of circulating immature granulocytes and is elevated in infection and inflammation. What is New: • DNI is a promising and easily accessible marker that can be used with other markers in the diagnosis and determines the severity of MIS C. • DNI is an easily accessible, inexpensive, and dynamic marker and its levels in simple hemogram analysis will guide pediatricians in determining the diagnosis and severity in MIS C.

show abstract

Section: Discussionmentioning

confidence: 99%

Delta neutrophil index and C-reactive protein: a potential diagnostic marker of multisystem inflammatory syndrome in children (MIS-C) with COVID-19

et al. 2021

View full text Add to dashboard Cite

show abstract

“…7 On the other hand, DNI provides an automated count of serum immature granulocytes and has the advantages of being rapid and highly reproducible. 16,19 Importantly, DNI can be obtained from routine sampling for complete blood count without additional examinations or costs. 19 We also found that a combination of NP and DNI was associated with surgical therapy and was an excellent indicator for predicting patients who need surgery.…”

Section: Discussionmentioning

confidence: 99%

“…11,13,15 Diagnostic criteria for DNI were reported to be higher in other systemic diseases such as intestinal obstruction (4.3%), acute prostatitis (3.5%), and Kawasaki disease (5.5%). 13,15,19 This can be explained by the characteristics of CRS, which are characterized by mild manifestations and seldom progress to systemic complications such as sepsis. This is in agreement with previous studies on airway diseases (DNI values of 1.7% and 1.8% in pneumonia and the common cold, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…16,19 Importantly, DNI can be obtained from routine sampling for complete blood count without additional examinations or costs. 19 We also found that a combination of NP and DNI was associated with surgical therapy and was an excellent indicator for predicting patients who need surgery. Therefore, radiological CT, endoscopic NP, and laboratory DNI could compensate for each other clinically.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Delta neutrophil index levels can be a good indicator to predict patients with chronic rhinosinusitis who need surgery

Son

Park

et al. 2021

Ear Nose Throat J

Self Cite

View full text Add to dashboard Cite

Objectives Predicting the need for surgical treatment among patients with chronic rhinosinusitis (CRS) is challenging. The delta neutrophil index (DNI) has been proposed as a useful laboratory marker of immature granulocytes, which indicates infection or severe inflammation in several diseases. This study evaluated DNI as an early predictor of the need for surgery in patients with CRS. Methods A total of 117 patients diagnosed with CRS were enrolled in this retrospective and observational study. Medical records, including symptoms data, WBC count, ESR level, LUC count, Lund-Mackay scores, and DNI, were reviewed. The receiver operating characteristic (ROC) curves were analyzed to determine the optimal cut-off values for predicting surgery. Results Among 117 patients, 49 patients (41.9%) needed surgical intervention. The areas under the WBC, ESR, LUC, and DNI ROC curves were .571, .600, .592, and .782, respectively. The optimal cut-off value of DNI to predict surgery was .9%. The prognostic precision of DNI showed that the sensitivity was 59.2% and the specificity was 98.5%. In the analysis of risk factors, DNI levels were significantly associated with surgical intervention (odds ratio, 2.22; 95% confidence interval, 1.48-3.34; P < .01). Conclusions The level of DNI, which reflects the severity of the disease, may be a useful predictor for determining the need for surgical intervention in patients with CRS. This is the first literature to verify the role of DNI in upper airway disease.

show abstract

“…During acute KS, patients develop neutrophilia [12]. Neutrophil activation has been linked to coronary artery involvement in KS [13]. Thrombocytosis is common [14].…”

Section: Laboratory Findings In Ksmentioning

confidence: 99%

Kawasaki syndrome: role of superantigens revisited

Leung

Schlievert

2020

The FEBS Journal

View full text Add to dashboard Cite

Kawasaki Syndrome (KS) is an acute vasculitis in children complicated by the development of heart disease. Despite its description over 50 years ago, the etiology of coronary artery disease in KS is unknown. High dose intravenous immunoglobulin is the most effective approach to reduce cardiovascular complications. It remains unclear why patients with KS develop coronary artery aneurysms. A subset of patients are resistant to immunoglobulin therapy. Given the heterogeneity of clinical features, variability of history, and therapeutic response, KS may be a cluster of phenotypes triggered by multiple infectious agents and influenced by various environmental, genetic, and immunologic responses. The cause of KS is unknown, and a diagnostic test remains lacking. A better understanding of mechanisms leading to acute KS would contribute to a more precision medicine approach for this complex disease. In the current viewpoint, we make the case for microbial superantigens as important causes of KS.

show abstract

Delta-neutrophil index: a potential predictor of coronary artery involvement in Kawasaki disease by retrospective analysis

Cited by 4 publications

References 19 publications

Delta neutrophil index and C-reactive protein: a potential diagnostic marker of multisystem inflammatory syndrome in children (MIS-C) with COVID-19

Delta neutrophil index and C-reactive protein: a potential diagnostic marker of multisystem inflammatory syndrome in children (MIS-C) with COVID-19

Delta neutrophil index levels can be a good indicator to predict patients with chronic rhinosinusitis who need surgery

Kawasaki syndrome: role of superantigens revisited

Contact Info

Product

Resources

About