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Zandstra, J; van de Geer, A; Tanck, MWT; van Stijn-Bringas Dimitriades, D; Aarts, CEM; Dietz, SM; van Bruggen, R; Schweintzger, NA; Zenz, W; Emonts, M; Zavadska, D; Pokorn, M; Usuf, E; Moll, HA; Schlapbach, LJ; Carrol, ED; Paulus, S; Tsolia, M; Fink, C; Yeung, S; Shimizu, C; Tremoulet, A; Galassini, R; Wright, VJ; Martinón-Torres, F; Herberg, J; Burns, J; Levin, M; Kuijpers, TW; EUCLIDS Consortium, PERFORM Consortium and UK Kawasaki Disease Genetics Study Network.
Biomarkers for the Discrimination of Acute Kawasaki Disease From Infections in Childhood.
Front Pediatr. 2020; 8(3):355-355 Doi: 10.3389/fped.2020.00355 [OPEN ACCESS]
Web of Science PubMed FullText FullText_MUG

Co-authors Med Uni Graz: Schweintzger Nina; Zenz Werner
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Abstract:: Background: Kawasaki disease (KD) is a vasculitis of early childhood mimicking several infectious diseases. Differentiation between KD and infectious diseases is essential as KD's most important complication-the development of coronary artery aneurysms (CAA)-can be largely avoided by timely treatment with intravenous immunoglobulins (IVIG). Currently, KD diagnosis is only based on clinical criteria. The aim of this study was to evaluate whether routine C-reactive protein (CRP) and additional inflammatory parameters myeloid-related protein 8/14 (MRP8/14 or S100A8/9) and human neutrophil-derived elastase (HNE) could distinguish KD from infectious diseases. Methods and Results: The cross-sectional study included KD patients and children with proven infections as well as febrile controls. Patients were recruited between July 2006 and December 2018 in Europe and USA. MRP8/14, CRP, and HNE were assessed for their discriminatory ability by multiple logistic regression analysis with backward selection and receiver operator characteristic (ROC) curves. In the discovery cohort, the combination of MRP8/14+CRP discriminated KD patients (n = 48) from patients with infection (n = 105), with area under the ROC curve (AUC) of 0.88. The HNE values did not improve discrimination. The first validation cohort confirmed the predictive value of MRP8/14+CRP to discriminate acute KD patients (n = 26) from those with infections (n = 150), with an AUC of 0.78. The second validation cohort of acute KD patients (n = 25) and febrile controls (n = 50) showed an AUC of 0.72, which improved to 0.84 when HNE was included. Conclusion: When used in combination, the plasma markers MRP8/14, CRP, and HNE may assist in the discrimination of KD from both proven and suspected infection. Copyright © 2020 Zandstra, van de Geer, Tanck, van Stijn-Bringas Dimitriades, Aarts, Dietz, van Bruggen, Schweintzger, Zenz, Emonts, Zavadska, Pokorn, Usuf, Moll, Schlapbach, Carrol, Paulus, Tsolia, Fink, Yeung, Shimizu, Tremoulet, Galassini, Wright, Martinón-Torres, Herberg, Burns, Levin, Kuijpers, EUCLIDS Consortium, PERFORM Consortium and UK Kawasaki Disease Genetics Study Network.
Find related publications in this database (Keywords): kawasaki disease; infectious disease; vasculitis; coronary aneurysm; biomarker; bacterial infection; viral infection