Serum procalcitonin concentration in patients with Kawasaki disease

Okada, Yasunori; Minakami, Hisanori; Tomomasa, Takeshi; Katô, Masahiko; Inoue, Yoshinari; Kozawa, Kunihisa; Kimura, Hirokazu; Morikawa, Akihiro

doi:10.1016/j.jinf.2003.08.002

Cited by 65 publications

(53 citation statements)

References 24 publications

(16 reference statements)

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“…A previous study reported that estimation of PCT will help differentiate KD from a septic condition because PCT does not increase in KD [27]. Another suggested that serum PCT is clinically useful for determining the severity of KD [28]; our finding of elevated PCT levels before IVIG and significantly decreased levels after IVIG agree with this, finding PCT to be clinically useful.…”

Section: Discussionsupporting

confidence: 87%

Persistent Endothelial Damage after Intravenous Immunoglobulin Therapy in Kawasaki Disease

Sakurai¹,

Takatsuka²,

Onaka³

et al. 2014

Int Arch Allergy Immunol

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Background: Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology. Although endothelial cell damage associated with vasculitis might lead to the hypercoagulability that is involved in coronary artery disease, the changes in coagulation after intravenous immunoglobulin therapy (IVIG) have not been well investigated in KD. The aims of this study were to address the changes in coagulation before and after IVIG in KD, and to further elucidate the coagulation-inflammation axis, with special attention to endothelial damage. Methods: We retrospectively collected the laboratory data before and after IVIG in 26 pediatric KD patients treated at the Nara Prefecture Western Medical Center between May 2010 and April 2012. Prothrombin time (PT), activated partial thromboplastin time (APTT) and levels of fibrin/fibrinogen degradation products (FDP) and D-dimer were assessed as coagulation markers. Fibrinogen, ferritin, serum amyloid A, procalcitonin and urine F2 microglobulin were assessed as inflammation markers. Thrombomodulin, antithrombin, factor VIII activity (FVIII:C), and von Willebrand factor antigen (VWF:Ag) were used to assess endothelial damage. Results: Prolonged PT and APTT before IVIG were significantly shortened after IVIG, and elevated levels of FDP and D-dimer were significantly decreased. Elevated levels of inflammation markers had decreased significantly after IVIG, but levels of FVIII:C and VWF:Ag remained high, even after IVIG. Conclusions: Ameliorated inflammation by IVIG might improve the hypercoagulable state. Nevertheless, our results suggest that endothelial damage might be prolonged in IVIG-treated patients. Control of endothelial damage in KD is critical. i 2014 S. Karger AG, Basel

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Section: Discussionsupporting

confidence: 87%

Persistent Endothelial Damage after Intravenous Immunoglobulin Therapy in Kawasaki Disease

Sakurai¹,

Takatsuka²,

Onaka³

et al. 2014

Int Arch Allergy Immunol

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“…For invasive fungal infections, PCT appears to be a less reliable indicator [8]. However, surgical trauma [1], burns [5], and Kawasaki disease [16] have been described as non-infectious triggers of a non-specific PCT response, while a physiologically higher normal range of serum PCT is found in the early newborn period [26].…”

Section: Discussionmentioning

confidence: 99%

Non-infectious causes of elevated procalcitonin and C-reactive protein serum levels in pediatric patients with hematologic and oncologic disorders

Dornbusch

Strenger

Sovinz

et al. 2008

Support Care Cancer

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“…Thus, it could be an infectious disease that involves an abnormal immune response to some pathogenic microorganisms. Okada et al [76] reported elevated PCT values in the acute-phase of KD patients, similar to what occurs during the acute phase of a bacterial infection. These authors consider PCT a reliable marker of disease activity in children with KD as well as a means for differentiating this entity from other systemic autoimmune diseases.…”

Section: Procalcitonin Values and Kawasaki Diseasementioning

confidence: 67%

Serum Procalcitonin Levels in Febrile Patients with Systemic Autoimmune Diseases

Trallero-Araguás¹,

Selva-O'Callaghan²,

Vilardell‐Tarrés³

2007

CRR

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Procalcitonin (PCT), the precursor of the hormone calcitonin, is a new parameter of inflammation. This acutephase hormokine seems to be more accurate for differentiating between bacterial infections and viral or non-infective causes of inflammation than other serological markers. PCT, which is induced in invasive bacterial infections, is routinely assayed in some intensive care, surgery, haematological units and emergency rooms to help determine the cause of a systemic inflammatory response syndrome (SIRS).Patients with systemic autoimmune diseases have a higher risk of developing severe systemic bacterial infections due to the disease itself and to the immunosuppressive therapy received. Distinguishing between infection and a disease flare is sometimes difficult. Strategies to reach a precise diagnosis are decisive to establish early, adequate patient management. Studies in febrile patients with systemic autoimmune diseases (systemic lupus erythematosus, antineutrophil cytoplasmic antibody-associated systemic vasculitis, and rheumatoid arthritis) suggest that elevated PCT concentrations offer good sensitivity and specificity for diagnosing systemic bacterial infection. Nevertheless, there is little published information on PCT levels in other autoimmune diseases and inflammatory processes. In this review we summarise the current evidence regarding the pathophysiological basis of systemic PCT production in sepsis and the results from current case series on the response of this peptide to infectious and non-infectious SIRS in systemic autoimmune diseases.

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Serum procalcitonin concentration in patients with Kawasaki disease

Cited by 65 publications

References 24 publications

Persistent Endothelial Damage after Intravenous Immunoglobulin Therapy in Kawasaki Disease

Persistent Endothelial Damage after Intravenous Immunoglobulin Therapy in Kawasaki Disease

Non-infectious causes of elevated procalcitonin and C-reactive protein serum levels in pediatric patients with hematologic and oncologic disorders

Serum Procalcitonin Levels in Febrile Patients with Systemic Autoimmune Diseases

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