Differentiation between incomplete Kawasaki disease and secondary hemophagocytic lymphohistiocytosis following Kawasaki disease using N-terminal pro-brain natriuretic peptide
PurposeHemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome with many causes, including Kawasaki disease (KD). The purpose of this study was to identify the laboratory tests needed to easily differentiate KD with HLH from incomplete KD alone.MethodsWe performed a retrospective st...
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| Format: | Article |
| Language: | English |
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Korean Pediatric Society
2018-05-01
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| Series: | Korean Journal of Pediatrics |
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| Online Access: | http://kjp.or.kr/upload/pdf/kjped-61-167.pdf |
| _version_ | 1819294868824915968 |
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| author | Jung Eun Choi Yujin Kwak Jung Won Huh Eun-Sun Yoo Kyung-Ha Ryu Sejung Sohn Young Mi Hong |
| author_facet | Jung Eun Choi Yujin Kwak Jung Won Huh Eun-Sun Yoo Kyung-Ha Ryu Sejung Sohn Young Mi Hong |
| author_sort | Jung Eun Choi |
| collection | DOAJ |
| description | PurposeHemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome with many causes, including Kawasaki disease (KD). The purpose of this study was to identify the laboratory tests needed to easily differentiate KD with HLH from incomplete KD alone.MethodsWe performed a retrospective study on patients diagnosed with incomplete KD and incomplete KD with HLH (HLH-KD) between January 2012 and March 2015. We compared 8 secondary HLH patients who were first diagnosed with incomplete KD with all 247 incomplete KD diagnosed patients during the study period. The complete blood count, erythrocyte sedimentation rate, platelet count, and serum total protein, albumin, triglyceride, C-reactive protein, N-terminal pro-brain natriuretic peptide (NT-proBNP), and ferritin levels were compared. Clinical characteristics and echocardiography findings were also compared between the 2 groups.ResultsThe total duration of fever was longer in the HLH-KD group than in the KD group. White blood cell and platelet counts were higher in the KD group. Alanine aminotransferase, ferritin, and coronary artery diameter were increased in the HLH-KD group compared with those in the KD group. The median of NT-proBNP was significantly higher in the HLH-KD group than in the KD group at 889.0 (interquartile range [IQR], 384.5–1792.0) pg/mL vs. 233.0 (IQR, 107.0–544.0) pg/mL.ConclusionThe NT-proBNP level may be helpful in distinguishing incomplete KD from KD with HLH. The NT-proBNP level should be determined in KD patients with prolonged fever, in addition to the white blood cell count, platelet count, and ferritin level, to evaluate secondary HLH. |
| first_indexed | 2024-12-24T04:33:10Z |
| format | Article |
| id | doaj.art-2b10c542f1694eed83026eb3d0ce7630 |
| institution | Directory Open Access Journal |
| issn | 1738-1061 2092-7258 |
| language | English |
| last_indexed | 2024-12-24T04:33:10Z |
| publishDate | 2018-05-01 |
| publisher | Korean Pediatric Society |
| record_format | Article |
| series | Korean Journal of Pediatrics |
| spelling | doaj.art-2b10c542f1694eed83026eb3d0ce76302022-12-21T17:15:19ZengKorean Pediatric SocietyKorean Journal of Pediatrics1738-10612092-72582018-05-0161516717310.3345/kjp.2018.61.5.16720125550722Differentiation between incomplete Kawasaki disease and secondary hemophagocytic lymphohistiocytosis following Kawasaki disease using N-terminal pro-brain natriuretic peptideJung Eun Choi0Yujin Kwak1Jung Won Huh2Eun-Sun Yoo3Kyung-Ha Ryu4Sejung Sohn5Young Mi Hong6Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, .KoreaDepartment of Pediatrics, Ewha Womans University School of Medicine, Seoul, .KoreaDepartment of Laboratory Medicine, Ewha Womans University School of Medicine, Seoul, .KoreaDepartment of Pediatrics, Ewha Womans University School of Medicine, Seoul, .KoreaDepartment of Pediatrics, Ewha Womans University School of Medicine, Seoul, .KoreaDepartment of Pediatrics, Ewha Womans University School of Medicine, Seoul, .KoreaDepartment of Pediatrics, Ewha Womans University School of Medicine, Seoul, .KoreaPurposeHemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome with many causes, including Kawasaki disease (KD). The purpose of this study was to identify the laboratory tests needed to easily differentiate KD with HLH from incomplete KD alone.MethodsWe performed a retrospective study on patients diagnosed with incomplete KD and incomplete KD with HLH (HLH-KD) between January 2012 and March 2015. We compared 8 secondary HLH patients who were first diagnosed with incomplete KD with all 247 incomplete KD diagnosed patients during the study period. The complete blood count, erythrocyte sedimentation rate, platelet count, and serum total protein, albumin, triglyceride, C-reactive protein, N-terminal pro-brain natriuretic peptide (NT-proBNP), and ferritin levels were compared. Clinical characteristics and echocardiography findings were also compared between the 2 groups.ResultsThe total duration of fever was longer in the HLH-KD group than in the KD group. White blood cell and platelet counts were higher in the KD group. Alanine aminotransferase, ferritin, and coronary artery diameter were increased in the HLH-KD group compared with those in the KD group. The median of NT-proBNP was significantly higher in the HLH-KD group than in the KD group at 889.0 (interquartile range [IQR], 384.5–1792.0) pg/mL vs. 233.0 (IQR, 107.0–544.0) pg/mL.ConclusionThe NT-proBNP level may be helpful in distinguishing incomplete KD from KD with HLH. The NT-proBNP level should be determined in KD patients with prolonged fever, in addition to the white blood cell count, platelet count, and ferritin level, to evaluate secondary HLH.http://kjp.or.kr/upload/pdf/kjped-61-167.pdfMucocutaneous lymph node syndromeHemophagocytic lymphohistiocytosisBrain natriuretic peptideFerritin |
| spellingShingle | Jung Eun Choi Yujin Kwak Jung Won Huh Eun-Sun Yoo Kyung-Ha Ryu Sejung Sohn Young Mi Hong Differentiation between incomplete Kawasaki disease and secondary hemophagocytic lymphohistiocytosis following Kawasaki disease using N-terminal pro-brain natriuretic peptide Korean Journal of Pediatrics Mucocutaneous lymph node syndrome Hemophagocytic lymphohistiocytosis Brain natriuretic peptide Ferritin |
| title | Differentiation between incomplete Kawasaki disease and secondary hemophagocytic lymphohistiocytosis following Kawasaki disease using N-terminal pro-brain natriuretic peptide |
| title_full | Differentiation between incomplete Kawasaki disease and secondary hemophagocytic lymphohistiocytosis following Kawasaki disease using N-terminal pro-brain natriuretic peptide |
| title_fullStr | Differentiation between incomplete Kawasaki disease and secondary hemophagocytic lymphohistiocytosis following Kawasaki disease using N-terminal pro-brain natriuretic peptide |
| title_full_unstemmed | Differentiation between incomplete Kawasaki disease and secondary hemophagocytic lymphohistiocytosis following Kawasaki disease using N-terminal pro-brain natriuretic peptide |
| title_short | Differentiation between incomplete Kawasaki disease and secondary hemophagocytic lymphohistiocytosis following Kawasaki disease using N-terminal pro-brain natriuretic peptide |
| title_sort | differentiation between incomplete kawasaki disease and secondary hemophagocytic lymphohistiocytosis following kawasaki disease using n terminal pro brain natriuretic peptide |
| topic | Mucocutaneous lymph node syndrome Hemophagocytic lymphohistiocytosis Brain natriuretic peptide Ferritin |
| url | http://kjp.or.kr/upload/pdf/kjped-61-167.pdf |
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