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Huijuan K, Yaping D, Bo W, Miao H, Guanghui Q, Wenhua Y. Combined IFN-β and PLT Detection Can Identify Kawasaki Disease Efficiently. Front Pediatr 2021; 9:624818. [PMID: 33968843 PMCID: PMC8100027 DOI: 10.3389/fped.2021.624818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/22/2021] [Indexed: 12/19/2022] Open
Abstract
Objective: To evaluate the value of combined interferon β (IFN-β) and platelet (PLT) detection for Kawasaki disease (KD) identification. Methods: Forty-four children who were newly diagnosed with KD were selected as the KD group. They were divided into acute phase of KD and subacute phase of KD. They were also separated into groups with and without coronary artery disease (CAD) (CAD+ and CAD-, respectively). Meanwhile, 44 children hospitalized with febrile disease and 44 healthy children were selected as a febrile control group and normal control group, whom were attended to at Children's Hospital of Soochow University at the same time. We detected the concentration of IFN-β and PLT of peripheral blood serum for all three groups and analyzed the difference. Results: At acute and subacute phases of KD, both IFN-β and PLT are higher than both the febrile control group and healthy control group, especially at subacute phase; the difference between groups was statistically significant, P < 0.05. Receiver operating characteristic (ROC) curve showed that the areas under the ROC curve (AUCs) of IFN-β and PLT at acute phase of KD were 0.81 and 0.72, respectively; the sensitivity and specificity were 97.22 and 63.64%, and 57.89 and 73.86%, respectively. The AUCs of combined IFN-β and PLT were 0.81 at acute phase and 0.96 at subacute phase of KD, with sensitivity and specificity of 97.22 and 55.26%, and 86.36 and 100%, respectively. The cutoff value of combined IFN-β and PLT detection was IFN-β = 3.51 pg/ml and PLT = 303 × 109/L at acute phase of KD, IFN-β = 4.21 pg/ml and PLT = 368 × 109/L at subacute phase from plot vs. criterion values. However, there are no significant differences between the CAD- group and the CAD+ group for combined IFN-β and PLT, both P > 0.5, neither at acute nor at subacute phase of KD. Conclusion: Combined IFN-β and PLT detection is an efficient biomarker for KD identification. The cutoff values are IFN-β = 3.51 pg/ml and PLT = 303 × 109/L at acute phase of KD and IFN-β = 4.21 pg/ml and PLT = 368 × 109/L at subacute phase.
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Affiliation(s)
- Kan Huijuan
- Department of Cardiology, Children's Hospital Soochow University, Suzhou, China.,Department of Pediatric, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Dong Yaping
- Department of Cardiology, Children's Hospital Soochow University, Suzhou, China
| | - Wang Bo
- Department of Cardiology, Children's Hospital Soochow University, Suzhou, China
| | - Hou Miao
- Department of Cardiology, Children's Hospital Soochow University, Suzhou, China
| | - Qian Guanghui
- Department of Cardiology, Children's Hospital Soochow University, Suzhou, China
| | - Yan Wenhua
- Department of Cardiology, Children's Hospital Soochow University, Suzhou, China
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Adenovirus Infections in Immunocompetent Children. Curr Infect Dis Rep 2020. [DOI: 10.1007/s11908-020-00736-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Huang Z, Tan XH, Wang H, Pan B, Lv TW, Tian J. A New Diagnostic Model to Distinguish Kawasaki Disease From Other Febrile Illnesses in Chongqing: A Retrospective Study on 10,367 Patients. Front Pediatr 2020; 8:533759. [PMID: 33304865 PMCID: PMC7693557 DOI: 10.3389/fped.2020.533759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 09/17/2020] [Indexed: 12/19/2022] Open
Abstract
Objective: Kawasaki disease (KD) is one of the most prevailing vasculitis among infants and young children, and has become the leading cause of acquired heart disease in childhood. Delayed diagnosis of KD can lead to serious cardiovascular complications. We sought to create a diagnostic model to help distinguish children with KD from children with other febrile illnesses [febrile controls (FCs)] to allow prompt treatment. Methods: Significant independent predictors were identified by applying multivariate logistic regression analyses. A new diagnostic model was constructed and compared with that from diagnostic tests created by other scholars. Results: Data from 10,367 patients were collected. Twelve independent predictors were determined: a lower percentage of monocytes (%MON), phosphorus, uric acid (UA), percentage of lymphocyte (%LYM), prealbumin, serum chloride, lactic dehydrogenase (LDH), aspartate aminotransferase: alanine transaminase (AST: ALT) ratio, higher level of globulin, gamma-glutamyl transpeptidase (GGT), platelet count (PLT), and younger age. The AUC, sensitivity, and specificity of the new model for cross-validation of the KD diagnosis was 0.906 ± 0.006, 86.0 ± 0.9%, and 80.5 ± 1.5%, respectively. An equation was presented to assess the risk of KD, which was further validated using KD (n = 5,642) and incomplete KD (n = 809) cohorts. Conclusions: Children with KD could be distinguished effectively from children with other febrile illnesses by documenting the age and measuring the level of %MON, phosphorus, UA, globulin, %LYM, prealbumin, GGT, AST:ALT ratio, serum chloride, LDH, and PLT. This new diagnostic model could be employed for the accurate diagnosis of KD.
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Affiliation(s)
- Zhilin Huang
- Department of Heart, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xu-Hai Tan
- Department of Pediatric, People's Hospital of Hongan, Hubei, China
| | - Haolin Wang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Bo Pan
- Department of Heart, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Tie-Wei Lv
- Department of Heart, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Tian
- Department of Heart, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
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Zheng X, Wu W, Zhang Y, Wu G. Changes in and significance of platelet function and parameters in Kawasaki disease. Sci Rep 2019; 9:17641. [PMID: 31776411 PMCID: PMC6881449 DOI: 10.1038/s41598-019-54113-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 11/05/2019] [Indexed: 02/05/2023] Open
Abstract
Kawasaki disease (KD) is a systemic febrile, inflammatory vascular disease of unknown etiology. The coronary artery abnormality (CAA) caused by KD has become the most commonly acquired heart disease in children. Initial treatment of intravenous immunoglobulin (IVIG) can reduce the incidence of CAA. Thrombocytosis is common during the course of KD, but changes in and significances of platelet function and parameters are unclear. In this study, we enrolled 120 patients, including 40 patients with KD, 40 febrile controls, and 40 afebrile controls. The platelet function was assessed using the platelet function analyzer (PFA)-200. Platelet parameters, including platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and platelet hematocrit (PCT) were measured. In the febrile period, the PDW and MPV were lower in KD patients (P < 0.05). The platelet function did not change significantly during the febrile period of KD but weakened in the defervescence phase. No significant differences between the CAA and normal groups, and between IVIG resistance and response groups. The diagnostic cutoff value of the PDW level for predicting KD was 10.85 fL with a sensitivity of 55% and a specificity of 77.5% (area under curve (AUC) = 0.690, 95% confidence interval (CI): 0.574–0.806, P < 0.01). Besides, the MPV level was 9.55 fL with sensitivity of 75% and specificity of 70% (AUC = 0.733, 95%CI: 0.620–0.846, P < 0.001). This is the first longitudinal study of platelet function changes in KD patients using PFA-200. Besides, lower PDW and MPV may be available markers for early diagnosis of KD.
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Affiliation(s)
- Xiaolan Zheng
- Department of Pediatrics, West China Second Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.,West China Medical School, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Wenchao Wu
- Laboratory of Cardiovascular Diseases, Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Zhang
- Department of Pediatrics, West China Second Hospital, Sichuan University, Chengdu, Sichuan, 610041, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
| | - Gang Wu
- Department of Pediatrics, West China Second Hospital, Sichuan University, Chengdu, Sichuan, 610041, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
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Lipe DN, Bridges LC. Kawasaki Disease Presenting as Acute Acalculous Cholecystitis. Clin Pract Cases Emerg Med 2019; 3:383-386. [PMID: 31763594 PMCID: PMC6861022 DOI: 10.5811/cpcem.2019.8.44255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/09/2019] [Accepted: 08/15/2019] [Indexed: 12/19/2022] Open
Abstract
Acute acalculous cholecystitis (AAC) is a rare, potentially serious disease that has been associated with Kawasaki disease (KD) in children. Studies suggest that patients presenting with severe abdominal symptoms secondary to KD have increased resistance to intravenous immunoglobulin (IVIG), and a higher rate of coronary artery aneurysms. We describe an eight-year-old boy who presented to the emergency department with severe abdominal pain and was diagnosed with AAC and KD. He was treated with IVIG and high-dose aspirin, achieving good response with complete symptom resolution. He had no coronary artery aneurysms or further complications and was discharged after three days.
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Affiliation(s)
- Demis N Lipe
- MD Anderson Cancer Center, Department of Emergency Medicine, Houston, Texas
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