Serum Procalcitonin Value is Useful for Predicting Severity of Kawasaki Disease

Yoshikawa, Hiroyuki; Nomura, Yoshio; Masuda, Kiminori; Koriya, Chihaya; Arata, Michiko; Hazeki, Daisuke; Yanagimoto, Kosuke; Ueno, Koichi; Eguchi, Takashi; Kawano, Yoshifumi

doi:10.1097/inf.0b013e3182463879

Cited by 27 publications

(21 citation statements)

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“…However, more nonresponders than responders had a PCT level >1.0 ng/mL, and there was a significant difference in PCT between responders and nonresponders in the KD group after adjustment for age by using ANCOVA. Another study investigating responders and nonresponders to initial IVIG treatment demonstrated that PCT levels were significantly higher in nonresponders than in responders10). This result was similar to the findings of our study.…”

Section: Discussionsupporting

confidence: 92%

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Clinical usefulness of serum procalcitonin level in distinguishing between Kawasaki disease and other infections in febrile children

2017

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PurposeThe aims of this study were to compare serum procalcitonin (PCT) levels between febrile children with Kawasaki disease (KD) and those with bacterial or viral infections, and assess the clinical usefulness of PCT level in predicting KD.MethodsSerum PCT levels were examined in febrile pediatric patients admitted between August 2013 and August 2014. The patients were divided into 3 groups as follows: 49 with KD, 111 with viral infections, and 24 with bacterial infections.ResultsThe mean PCT level in the KD group was significantly lower than that in the bacterial infection group (0.82±1.73 ng/mL vs. 3.11±6.10 ng/mL, P=0.002) and insignificantly different from that in the viral infection group (0.23±0.34 ng/mL,P=0.457). The mean erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level in the KD group were significantly higher than those in the viral and bacterial infection groups (P<0.001 and P<0.001 for ESR, P<0.001 and P=0.005 for CRP, respectively). The proportion of patients in the KD group with PCT levels of >1.0 ng/mL was significantly higher in the nonresponders to the initial intravenous immunoglobulin treatment than in the responders (36% vs. 8%, P=0.01).ConclusionPCT levels may help to differentiate KD from bacterial infections. A combination of disease markers, including ESR, CRP, and PCT, may be useful for differentiating between KD and viral/bacterial infections.

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Section: Discussionsupporting

confidence: 92%

“…Although the clinical impact of serum PCT levels in patients with KD has not been determined, the relation between PCT and KD severity, and the comparison of PCT levels between complete and incomplete KD were also reported1011).…”

Section: Introductionmentioning

confidence: 99%

Clinical usefulness of serum procalcitonin level in distinguishing between Kawasaki disease and other infections in febrile children

2017

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“…Previous studies have observed that non‐infectious triggers, such as surgical trauma , burns, Kawasaki disease , and adult onset Still's disease can induce PCT elevation . In HSCT recipients, donor leukocytes might result in PCT elevation.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the diagnostic value of procalcitonin and C‐reactive protein after hematopoietic stem cell transplantation: a systematic review and meta‐analysis

Lyu¹,

Yu²,

Zhu³

2013

Transplant Infectious Dis

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“…IVIGR poses great harm to KD patients, and early identification and adoption of more aggressive treatment measures can effectively reduce vascular complications and improve prognoses. A cluster of risk factors for IVIGRKD have been reported in the past decade including elevated total bilirubin and aspartate transaminase [ 10 ], PCT > 0.5 ng/ml [ 11 ], band count > 10%, albumin ≤ 30 g/L and abnormal first echocardiographic results [ 12 ], elevated neutrophil ratio and alanine aminotransferase, low albumin (< 29 g/L) and pericardial effusion [ 13 ], elevated total bilirubin and C-reactive protein [ 14 ], gallbladder effusion and cholecystitis [ 15 ], C-reactive protein ≥ 10 mg/dL, lactate dehydrogenase ≥ 590 IU/L and hemoglobin ≥ 110 g/L [ 16 ]. Previous studies added to our understanding of IVIGRKD and also raised the demand on how to accurately predict its occurrence.…”

Section: Discussionmentioning

confidence: 99%

A new model to predict intravenous immunoglobin-resistant Kawasaki disease

et al. 2017

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ObjectivesTo clarify the independent risk factors and construct predictive model for intravenous immunoglobin (IVIG)-resistant KD (IVIGRKD).ResultsThe ratio of male to female in the overall samples was 1.62:1 and the incidence of IVIGR was 17.9%. Multivariate regression analysis showed that the OR (95% CI) values of fever duration ≥ 7 days, delayed diagnosis, gamma-glutamyl transferase ≥ 25 U/L, serum sodium ≤ 135 mmol/L, neutrophil-to-lymphocyte ratio ≥ 2.8 and platelets ≤ 350 × 109/L were 2.94 (2.17–4.00), 1.64 (1.07–2.53), 1.38 (1.07–1.79), 1.68 (1.30–2.19), 1.58 (1.22–2.06) and 1.39 (1.08–1.80), respectively. Based on these OR values, a new predictive model was established with an AUC of 0.685, a sensitivity of 60.7% and a specificity of 66.5%, and showed superiority to formerly reported models. Further analysis of patients ≤ 6 months old gave rise to improved predictions for IVIGRKD with an AUC of 0.746 relative the new model for the total samples.Materials and MethodsA total of 2,126 KD cases were enrolled in this study. Clinical indicators showing significant differences were screened using univariate analysis, and the independent risk factors were further elucidated using multivariate regression analysis. A new model was constructed, and the predictive ability was evaluated with the area under the curve (AUC) value and the sensitivity and specificity by using the receiver operating characteristic (ROC) curve.ConclusionsThe new model for predicting IVIGRKD in this study is superior to those reported previously, and further analysis of patients with IVIGRKD younger than 6 months old allowed optimization of the predictive model.

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Serum Procalcitonin Value is Useful for Predicting Severity of Kawasaki Disease

Cited by 27 publications

References 1 publication

Clinical usefulness of serum procalcitonin level in distinguishing between Kawasaki disease and other infections in febrile children

Clinical usefulness of serum procalcitonin level in distinguishing between Kawasaki disease and other infections in febrile children

Comparison of the diagnostic value of procalcitonin and C‐reactive protein after hematopoietic stem cell transplantation: a systematic review and meta‐analysis

A new model to predict intravenous immunoglobin-resistant Kawasaki disease

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