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Yanagimachi M, Fukuda S, Tanaka F, Iwamoto M, Takao C, Oba K, Suzuki N, Kiyohara K, Kuranobu D, Tada N, Nagashima A, Ishii T, Ino Y, Kimura Y, Nawa N, Fujiwara T, Naruto T, Morio T, Doi S, Mori M. Leucine-rich alpha-2-glycoprotein 1 and angiotensinogen as diagnostic biomarkers for Kawasaki disease. PLoS One 2021; 16:e0257138. [PMID: 34499692 PMCID: PMC8428710 DOI: 10.1371/journal.pone.0257138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 08/24/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Kawasaki disease (KD) is a systemic vasculitis in childhood that can lead to coronary artery lesions (CALs). Although early diagnosis and treatment is important for preventing KD patients from development of CALs, diagnosis depends on the clinical features of KD. We studied the usefulness of leucine-rich alpha-2-glycoprotein 1 (LRG1) and angiotensinogen (AGT), previously reported as KD-related proteins, for KD diagnosis and estimation of intravenous immunoglobulin (IVIG) efficacy. METHODS We undertook a prospective cohort study with patients having two or more KD symptoms in multiple centers in Japan, between July 2017 and February 2019. RESULTS Two hundred forty-two patients were included. In multivariable analysis, one unit increase in LRG1 was associated with higher odds of KD diagnosis (Odds ratio [OR] 1.02 [95% confidence interval (CI) 1.001-1.03]). Double-positivity for AGT (≥ 26 μg/mL) and LRG1 (≥ 123.5 μg/mL) was an independent biomarker for KD diagnosis in both the total cohort and the subgroup of patients with two to four KD symptoms (OR 5.01 [95% CI 1.86-13.50] and 3.71 [95% CI 1.23-11.16], respectively). There was no association between LRG1/AGT and IVIG efficacy. CONCLUSION Double-positivity for LRG1 and AGT is an biomarker for KD diagnosis, especially useful in diagnosing incomplete KD from non-KD. Future studies with larger cohorts should seek to determine whether LRG1 and AGT are valuable as definitive data referred at the diagnosis of KD and for estimating the risk of CALs.
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Affiliation(s)
- Masakatsu Yanagimachi
- Department of Pediatrics, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Hematology/Oncology, Kanagawa Children’s Medical Center, Yokohama, Japan
| | - Sayaka Fukuda
- Department of Pediatrics, Saiseikai Yokohama-shi Tobu Hospital, Yokohama, Japan
| | - Fumiko Tanaka
- Department of Pediatrics, Saiseikai Yokohama-shi Nanbu Hospital, Yokohama, Japan
| | - Mari Iwamoto
- Department of Pediatrics, Saiseikai Yokohama-shi Tobu Hospital, Yokohama, Japan
| | - Chiho Takao
- Department of Pediatrics, Saiseikai Yokohama-shi Nanbu Hospital, Yokohama, Japan
| | - Kunihiro Oba
- Department of Pediatrics, Showa General Hospital, Tokyo, Japan
| | - Natsuko Suzuki
- Department of Pediatrics, Japanese Red Cross Musashino Hospital, Tokyo, Japan
| | - Koji Kiyohara
- Department of Pediatrics, Tokyo-Kita Medical Center, Tokyo, Japan
| | - Dai Kuranobu
- Department of Pediatrics, Kawaguchi Municipal Medical Center, Saitama, Japan
| | - Norimasa Tada
- Department of Pediatrics, Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - Ayako Nagashima
- Department of Pediatrics, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Pediatrics, Tokyo-Kita Medical Center, Tokyo, Japan
| | - Taku Ishii
- Department of Pediatrics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoko Ino
- Advanced Medical Research Center, Yokohama City University, Yokohama, Japan
| | - Yayoi Kimura
- Advanced Medical Research Center, Yokohama City University, Yokohama, Japan
| | - Nobutoshi Nawa
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takuya Naruto
- Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomohiro Morio
- Department of Pediatrics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shouzaburo Doi
- Department of Community Pediatrics, Perinatal, and Maternal Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masaaki Mori
- Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- * E-mail:
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