The Usefulness of N-terminal Pro-Brain Natriuretic Peptide in the Diagnosis of the Kawasaki Disease

ABSTRACT

PURPOSE: Kawasaki disease (KD) is a well-known generalized vasculitis involving cardiovascular system and there is no specific biochemical marker for detecting this disease. We performed a study to investigate the usefulness of plasma NT-proBNP as a biochemical marker for the diagnosis of KD. METHODS: We measured the plasma NT-proBNP concentrations in acute (complete KD, n=48; incomplete KD, n=10) and convalescent (n=31) phases of KD, and in patients with other acute febrile diseases (n=24) associated with rash or cervical lymphadenitis. RESULTS: The plasma NT-proBNP concentrations in patients with both complete and incomplete KD in the acute phase were significantly higher than in those with febrile illness (complete KD, 1211.9+/-1653.7 pg/mL; incomplete KD, 2245.9+/-2720.7 pg/mL versus febrile illness, 138.8+/-104.9 pg/mL; P<0.001). Also, the level of plasma NT-proBNP decreased significantly in the convalescent phase compared with level of NT-proBNP in acute phase (n=31, acute phase, 1390.2+/-1891.8 pg/ml; convalescent phase, 88.3+/-125.3 pg/mL; P<0.001). There were no significant correlations between the plasma concentrations of NT-proBNP and the clinical, laboratory and echocardiographic findings of acute phase of KD. The best cut-off level of NT-proBNP for the differential diagnosis of KD with other febrile disease was determined to be 287.0 pg/mL (sensitivity 0.862, specificity 0.917). CONCLUSION: We suggest that the measurement of plasma NT-proBNP level may be helpful for the definite diagnosis of KD, especially incomplete KD. Further studies are needed to investigate the usefulness of the NT-proBNP as a predictive marker for cardiovascular complications.