Usefulness of brain natriuretic peptide to distinguish Kawasaki disease from cervical lymphadenitis

Background Cervical lymphadenitis (CL) cannot be easily distinguished from Kawasaki disease (KD). We therefore explored whether brain natriuretic peptide (BNP) levels are useful in this context. Methods We retrospectively analyzed 14 children with CL and 177 children with KD. Patients with KD were d...

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Published in:Pediatrics international 2022-01, Vol.64 (1), p.e15050-n/a
Main Authors: Muto, Taichiro, Masuda, Yu, Nakamura, Nami, Numoto, Shingo, Kodama, Shunsuke, Miyamoto, Ryosuke, Miyata, Kenji, Hayakawa, Tomohito, Mori, Hiromitsu, Kuroyanagi, Yoshiyuki, Akaihata, Mitsuko, Iwayama, Hideyuki, Kurahashi, Hirokazu, Shimomura, Yasuhito, Nagai, Takuhito, Hori, Toshinori, Agata, Hiroatsu, Okumura, Akihisa
Format: Article
Language:English
Subjects:
Biomarkers
Brain natriuretic peptide
cervical lymphadenitis
Child
Confidence intervals
fever
Humans
Kawasaki disease
Lymphadenitis
Lymphadenitis - diagnosis
Lymphadenopathy
Mucocutaneous lymph node syndrome
Mucocutaneous Lymph Node Syndrome - diagnosis
Natriuretic Peptide, Brain
Pediatrics
Peptide Fragments
Peptides
Retrospective Studies
ROC Curve
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Summary:Background Cervical lymphadenitis (CL) cannot be easily distinguished from Kawasaki disease (KD). We therefore explored whether brain natriuretic peptide (BNP) levels are useful in this context. Methods We retrospectively analyzed 14 children with CL and 177 children with KD. Patients with KD were divided into three groups according to their clinical symptoms at hospitalization – 97 patients had typical KD, 35 had node‐first KD (NFKD), and 45 had KD without lymphadenopathy. We reviewed data on clinical and laboratory parameters, including serum BNP levels, at hospitalization together with factors that might distinguish KD from CL. Results Patients with CL were older than those with KD. Serum BNP levels were higher in all the KD groups than in the CL group. Multivariate logistic regression analyses indicated that higher BNP levels were associated with NFKD (odds ratio: 1.12, 95% confidence interval: 1.01–1.25). The receiver operating characteristic curve yielded a BNP cutoff of 18.3 pg/mL, with a sensitivity of 0.680, a specificity of 0.857, and an area under the curve of 0.806 (95% confidence interval: 0.665–0.947). Conclusions Serum BNP levels can be used to distinguish KD from CL, especially in patients with NFKD.
ISSN:1328-8067
1442-200X
DOI:10.1111/ped.15050