Kawasaki disease (KD) is an acute
systemic vasculitis associated with the development of coronary arterial lesions (CALs) occurring in 3-5% of children treated by
intravenous immune globulin (
IVIG). However, a considerable number of patients who are not responding to
IVIG are at much higher risk. Although studies have explored potential
biomarkers to predict patients with KD who are at risk of CAL, no useful single marker exists. We hypothesized that the serum concentrations of the N-terminal moiety of
brain natriuretic peptide (
NT-proBNP) can be useful to predict CAL. Forty-three children with KD (29 males and 14 females) were enrolled in this study. Despite
IVIG, 6 of the 43 patients developed CAL. There were, however, no significant differences in variables between children with CAL and those without CAL: These include age, gender, day of the illness, leukocyte count, and the serum levels of
sodium,
C-reactive protein, and
albumin. The serum
NT-proBNP level was significantly higher in children with CAL than those without CAL (2,611 ± 1,699 vs. 1,073 ± 1,427 pg/ml; P = 0.03): the cutoff value of 1,000 pg/ml to predict CAL produced a specificity of 0.68, sensitivity of 0.83, and an odds ratio as high as 10.4. In conclusion,
NT-proBNP is increased in KD patients who are developing CAL, and patients with an elevated serum
NT-proBNP >1,000 pg/ml have a risk of CAL ~10 times higher than that of patients with a modest increase.