Peptide In Children Research Articles

Multisystem inflammatory syndrome in children: an Umbrella review.

We conducted an Umbrella review of eligible studies to evaluate what patient features have been investigated in the multisystem inflammatory syndrome in children (MIS-C) population, in order to guide future investigations. We comprehensively searched MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from December 1, 2019 to the May 6, 2022. The time period was limited to cover the coronavirus disease-2019 (COVID-19) pandemic period. The protocol was registered in the PROSPERO registry (CRD42022340228). Eligible studies included (1) a study population of pediatric patients ≤21years of age diagnosed with MIS-C; (2) an original Systematic review or Mata-analysis; (3) published 2020 afterward; and (4) was published in English. A total of 41 studies met inclusion criteria and underwent qualitative analysis. 28 studies reported outcome data of MIS-C. 22 studies selected clinical features of MIS-C, and 6 studies chose demographic data as a main topic. The mortality rate for children with MIS-C was 1.9% (interquartile range (IQR) 0.48), the ICU admission rate was 72.6% (IQR 8.3), and the extracorporeal membrane oxygenation rate was 4.7% (IQR 2.0). A meta-analysis of eligible studies found that cerebral natriuretic peptide in children with MIS-C was higher than that in children with COVID-19, and that the use of intravenous immunoglobulin (IVIG) in combination with glucocorticoids to treat MIS-C compared to IVIG alone was associated with lower treatment failure. In the future, for patients with MIS-C, studies focused on safety of surgery requiring general anesthesia, risk factors, treatment, and long-term outcomes are warranted.

Diagnostic Accuracy of Tissue Transglutaminase and Combined Assay of Tissue Transglutaminase and Deamidated Gliadin Peptide in Children with Coeliac Disease: A Cross-sectional Study

Introduction: Coeliac Disease (CD) is a systemic immune disorder caused by gluten in genetically susceptible individuals. A serological screening assay for CD has been designed to detect Immunoglobulin A (IgA) and IgG anti-tissue Transglutaminase (a-tTG) and IgA and IgG Deamidated Gliadin Peptide antibodies (a-DGP) simultaneously. The seronegative gap can be closed when these two antigens are combined on a single solid phase. This is primarily because untreated CD children who are negative for antibodies of one of the antigens may exhibit a positive result for the other. Aim: To determine the diagnostic parameters {sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV)} of tTG-IgA and htTG-DGP (Coeliac fusion- a combination of IgA and IgG to human tTG and synthetic DGP) for the diagnosis of CD in clinically symptomatic children. Materials and Methods: This cross-sectional study was conducted at the Paediatric Outpatient Department (OPD) of Santokhba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India from April 2023 to November 2023. The study population comprised 45 children (age >6 months and <18 years) showing clinical features of CD. Considering biopsy as the gold standard, the diagnostic parameters (sensitivity, specificity, PPV, NPV) of tTG-IgA and htTG-DGP were calculated with a 95% confidence interval for both tests. To determine the agreement between the two tests, Cohen’s kappa was calculated. A p-value less than 0.05 was considered statistically significant. Results: Out of the study population, 23 (46%) CD patients were in the age group of 3-6 years, while 13 (26%) patients were in the age group of 6-9 years. A total of 24 (53.3%) CD patients were males, and 21 (46.7%) were females. Chronic diarrhoea was the most common clinical feature in 31 (62%) patients. Considering duodenal biopsy as the gold standard, the study results showed that the anti tTG-IgA antibody test had a sensitivity of 91.1%, specificity of 80%, PPV of 97.6, and NPV of 50%. In comparison, the htTG-DGP antibody test had a sensitivity of 95.6%, specificity of 100%, PPV of 100%, and NPV of 71.43%. Conclusion: Currently, tTG-IgA is considered the best CD screening test. However, the inclusion of DGP IgG could increase diagnostic sensitivity, and a Combined IgA/G-DGP/ tTG assay could be even better than tTG-IgA for the diagnosis of childhood CD.

The correlation between post-allo-HSCT CMV infection and the difference affinity of donor HLA-type recognition of CMV antigen peptide in children

目的探索儿童异基因造血干细胞移植（allo-HSCT）后供者HLA型别识别不同巨细胞病毒（CMV）抗原肽亲和力与发生CMV感染的相关性。方法回顾性分析武汉儿童医院血液肿瘤科146例allo-HSCT患儿移植后6个月内发生CMV再激活、CMV感染、CMV组织器官病的数据，分析其与供者HLA型别识别CMV抗原肽差异的相关性。结果纳入研究的146例移植后患儿中HLA型别与PP65单独高亲和力82例（56.16％），移植后发生CMV感染34例（41.46％）；IE-1高亲和力型5例，移植后感染0例；无明确亲和力多肽2例，感染0例；PP65+IE-1高亲和力型52例，移植后感染13例（25.00％）；与PP65和PP50共同高亲和力型5例，移植后感染3例；未遇到仅与PP50高亲和力HLA供者。与仅携带PP65高亲和力等位基因组比较，伴有IE-1高亲和力HLA位点供者移植后表现出更低的CMV感染发生率（22.81％对41.46％，P＝0.029）。结论CMV PP65和IE-1高亲和力型别HLA类型覆盖约99.8％的供者，选择CMV抗原肽IE-1高亲和力型别HLA供者或可降低儿童血液病患者allo-HSCT后CMV感染风险。

Prognostic role of brain natriuretic peptide in children of the first year of life with congenital heart defects: a prospective cohort study

Background. Congenital heart defects (CHD) are the most common type of developmental anomalies in children. At present the early diagnosis of congestive heart failure (CHF) and CHF-associated pathologic conditions is becoming increasingly important for optimization of protocols for following up pediatric patients in the primary health care settings.Objective. The study aimed at determining the prognostic role of brain natriuretic peptide (BNP) as a diagnostic marker of CHF progression and development of CHF-associated pathological conditions in babies with CHD during the first year of life.Methods. A prospective cohort study was carried out in a total of 114 children of the first year of life. The main study group was comprised of 61 children with confirmed diagnosis of CHD, and the control group of 53 health status group I–IIA children without CHD.Results. Diagnostic role of BNP elevation > 30 pg/mL was determined. At this BNP level the risk for developing stage 2A CHF increased 7-fold (OR 7.5 [1.8–31.5]), for developing functional class (FC) 2 CHF — nearly 5-fold (OR 4.6 [1.3–16.0]), and for FC 3 CHF such risk increased 9-fold (OR 9.2 [2.3–36.1]). Our results demonstrated that the BNP level measurements can be used in clinical practice to determine the likelihood of persistence of symptoms of perinatal CNS injuries during the first year of life (OR 7.6 [1.7–34.5]) and protein and energy deficit (PED) (OR 9.5 [2.5–35.5]) in children with CHD.

Prognostic role of brain natriuretic peptide in children of the first year of life with congenital heart defects: a prospective cohort study

Background. Congenital heart defects (CHD) are the most common type of developmental anomalies in children. At present the early diagnosis of congestive heart failure (CHF) and CHF-associated pathologic conditions is becoming increasingly important for optimization of protocols for following up pediatric patients in the primary health care settings.Objective. The study aimed at determining the prognostic role of brain natriuretic peptide (BNP) as a diagnostic marker of CHF progression and development of CHF-associated pathological conditions in babies with CHD during the first year of life.Methods. A prospective cohort study was carried out in a total of 114 children of the first year of life. The main study group was comprised of 61 children with confirmed diagnosis of CHD, and the control group of 53 health status group I–IIA children without CHD.Results. Diagnostic role of BNP elevation > 30 pg/mL was determined. At this BNP level the risk for developing stage 2A CHF increased 7-fold (OR 7.5 [1.8–31.5]), for developing functional class (FC) 2 CHF — nearly 5-fold (OR 4.6 [1.3–16.0]), and for FC 3 CHF such risk increased 9-fold (OR 9.2 [2.3–36.1]). Our results demonstrated that the BNP level measurements can be used in clinical practice to determine the likelihood of persistence of symptoms of perinatal CNS injuries during the first year of life (OR 7.6 [1.7–34.5]) and protein and energy deficit (PED) (OR 9.5 [2.5–35.5]) in children with CHD.

Prognostic role of brain natriuretic peptide in children of the first year of life with congenital heart defects: a prospective cohort study

Background. Congenital heart defects (CHD) are the most common type of developmental anomalies in children. At present the early diagnosis of congestive heart failure (CHF) and CHF-associated pathologic conditions is becoming increasingly important for optimization of protocols for following up pediatric patients in the primary health care settings.Objective. The study aimed at determining the prognostic role of brain natriuretic peptide (BNP) as a diagnostic marker of CHF progression and development of CHF-associated pathological conditions in babies with CHD during the first year of life.Methods. A prospective cohort study was carried out in a total of 114 children of the first year of life. The main study group was comprised of 61 children with confirmed diagnosis of CHD, and the control group of 53 health status group I–IIA children without CHD.Results. Diagnostic role of BNP elevation > 30 pg/mL was determined. At this BNP level the risk for developing stage 2A CHF increased 7-fold (OR 7.5 [1.8–31.5]), for developing functional class (FC) 2 CHF — nearly 5-fold (OR 4.6 [1.3–16.0]), and for FC 3 CHF such risk increased 9-fold (OR 9.2 [2.3–36.1]). Our results demonstrated that the BNP level measurements can be used in clinical practice to determine the likelihood of persistence of symptoms of perinatal CNS injuries during the first year of life (OR 7.6 [1.7–34.5]) and protein and energy deficit (PED) (OR 9.5 [2.5–35.5]) in children with CHD.

Активность антимикробных пептидов у детей с муковисцидозом

Активность антимикробных пептидов у детей с муковисцидозом

Detection and significance of calcitonin gene-related peptide in children with enterovirus 71 infected hand foot and mouth disease

Objective To detect the plasma calcitonin gene-related peptide (CGRP) in children with enterovirus 71(EV71) infected hand foot and mouth disease(HFMD), and explore the relationship between CGRP and the severity of EV71 infected HFMD. Methods Two hundred children with EV71 infected HFMD in Xi′an Children′s Hospital from January 2017 to December 2017 were selected as the research group, and 50 healthy children were selected as control group in the same period.According to the severity of the disease, the research group was divided into the mild group (n=142) and the severe group (n=58). The level of plasma CGRP was detected by ELISA. Results In acute stage, the level of CGRP in children with EV71 infected HFMD was lower than that in control group, and the difference was statistically significant (t=4.235, P<0.001). The level of CGRP in acute stage in severe group[(29.90±5.10)pg/ml] was significantly lower than that of the mild group[(35.51±5.48)pg/ml], and the difference was statistically significant (t=6.615, P=0.001). The level of CGRP in mild group[(35.51±5.48)pg/ml] was slightly lower than that of the control group[(36.63±5.65)pg/ml], but the difference was insignificant (t=1.120, P=0.086). In recovery stage, the level of CGRP in the severe group was obviously higher than that in the acute stage(t=5.924, P=0.003). According to the ROC curve of CGRP in mild and severe EV71 infected HFMD, the critical value of CGRP in mild and severe HFMD was 28.12 pg/ml, and the sensitivity was 80.0% and the specificity was 50.0%. Conclusion The CGRP is associated with the progression of EV71 HFMD, and when CGRP is lower than 28.12 pg/ml, suggesting the possibility of severe HFMD.The decrease of plasma CGRP may be a risk factor for the progression of EV71 infected HFMD. Key words: Hand foot and mouth disease; Enterovirus 71; Calcitonin gene-related peptide

Association of left atrial pressure with left atrial volume and N-terminal prohormone brain natriuretic peptide in children with cardiomyopathy.

Enlargement of the left atrium is a non-invasive marker of diastolic dysfunction of the left ventricle, a determinant of prognosis in children with cardiomyopathy. Similarly, N-terminal prohormone brain natriuretic peptide is a useful marker in the management of children with cardiomyopathy and heart failure. The aim of this study is to evaluate the association of left atrial pressures with left atrial volume and N-terminal prohormone brain natriuretic peptide in children with cardiomyopathy. This was a retrospective study reviewing the medical records of patients <18 years of age, who were diagnosed with cardiomyopathy or acute myocarditis with eventual development of cardiomyopathy. Left atrial volume by transthoracic echocardiogram and pulmonary capillary wedge pressure, a surrogate of left atrial pressure, obtained by means of cardiac catheterisation were analysed. In addition, N-terminal prohormone brain natriuretic peptide levels obtained at the time of the cardiac catheterisation were also reviewed. Statistical analysis was performed to evaluate the association of left atrial pressures with left atrial volume and N-terminal prohormone brain natriuretic peptide levels. There was a linear correlation of left atrial pressure estimated in the cardiac catheterisation with indexed left atrial volume (r=0.63; p<0.001) and left atrial volume z-scores (r=0.59; p<0.001). We found no statistically significant association between the left atrial pressure and N-terminal prohormone brain natriuretic peptide levels. Left atrial volume measured non-invasively by echocardiography can be used as a surrogate for left atrial pressure in assessing diastolic dysfunction of the left ventricle in children with cardiomyopathy. The larger the size of the left atrium, worse is the diastolic function of the left ventricle.

Comparison between Brain Natriuretic Peptide and Calcitonin Gene Related Peptide in Children with Dilated Cardiomyopathy

Background: Dilated cardiomyopathy (DCM) is revealed with the left ventricular dilatation and systolic dysfunction. This study was performed to determine the level of Calcitonin Gene Related Peptide (CGRP) and Brain Natriuretic Peptide (BNP) in children with dilated cardiomyopathy and controls and comparison of these two biomarkers in patients. Materials and Methods: This case-control study was performed from April 2014 to March 2015 on patients with DCM. The levels of BNP and CGRP were measured by ELISA and final amounts of biomarkers were compared with echocardiographic finding.37 DCM patients compared with 30 healthy children selected randomly from those who referred to the hospital for routine checkup. Results: In this study the mean age was 10.567± 5.50 and 12.135 ± 4.626 years for controls and cases, respectively (P=0.321). The majority of echocardiography indices in the left and right heart had different means in case and controls (P<0.05). Means of BNP were 213.814 ± 309.601 and 2.76± 1.013 for case and control groups, respectively (P< 0.001). Means of CGRP were 2.278±1.586 and 1.488±0.501 for case and control groups, respectively (P = 0.001). In the dilated cardiomyopathy children however, no significant relationship was observed between CGRP level and Ross classification, but observed a significant association between Ross classification and BNP (Chi square = 15.85 and P=0.001). Conclusion:The present research was performed on DCM patients and showed that most echocardiographic parameters, mean of CGRP and mean of BNP increased in patients compared to healthy children. The severity of illness based on the Ross classification showed significant and positive correlation with BNP level but not with CGRP. Probably could be concluded that, BNP would be a better biomarker in DCM patients.

Comparison between brain natriuretic peptide and calcitonin gene-related peptide in children with dilated cardiomyopathy and controls.

Background:Dilated cardiomyopathy (DCM) is revealed with the left ventricular dilatation and systolic dysfunction.Objective:This study was performed to determine the level of calcitonin gene-related peptide (CGRP) and brain natriuretic peptide (BNP) in children with DCM and controls and comparison of these two biomarkers in patients.Materials and Methods:This study was performed from April 2014 to March 2015 on patients with DCM. The levels of BNP and CGRP were measured by ELISA, and final amounts of biomarkers were compared with the echocardiographic finding.Results:In this study, the mean age was 10.567 ± 5.50 and 12.135 ± 4.626 years for controls and cases, respectively (P = 0.321). The majority of echocardiographic indices in the left and right heart had different means in cases and controls (P < 0.05). Means of BNP were 213.814 ± 309.601 and 2.76 ± 1.013 for case and control, respectively (P < 0.001). Means of CGRP were 2.278 ± 1.586 and 1.488 ± 0.501 for cases and controls, respectively, (P = 0.001). In the patients group, however, no significant relationship was observed between CGRP level and Ross classification but observed a direct relationship of Ross classification with BNP (χ2 = 15.845, P < 0.05).Conclusions:The present research was performed on DCM patients and showed that most echocardiographic parameters, mean of CGRP and mean of BNP increased in patients compared to healthy children. The severity of illness based on the Ross classification showed significant and positive correlation with BNP level but not with CGRP. Probably, it could be concluded that BNP would be a better biomarker in DCM patients.

N-terminal brain natriuretic peptide in children with different forms of primary hypertension

N-terminal brain natriuretic peptide in children with different forms of primary hypertension

Prognostic value of N-terminal fragment of brain natriuretic peptide in pediatric cardiac surgery

Aim. To study the level of the N-terminal fragment of brain natriuretic peptide in children with congenital heart disease after surgical treatment and to determine its prognostic value in the postoperative period.&#x0D; Methods. A preoperative and postoperative examination of 113 children with congenital heart disease who were treated in the cardiac surgery department, was performed. Patients were allocated to four groups depending on the functional class of heart failure. Serum concentration of N-terminal brain natriuretic peptide fragment was determined by electrochemiluminescence before and one day after the surgery.&#x0D; Results. Postoperative levels of the N-terminal fragment of brain natriuretic peptide correlated with the duration of mechanical ventilation, the time that patient spends in the intensive care unit, the intensity of cardiotonic support. On the 1st day after the surgical intervention the concentration of this peptide was significantly increased in patients of the first, second and third group, by average of 7.8 times, due to the direct effect on the heart cells, surgical trauma, influence of cardioplegic solution, heart function alteration and heart failure associated with operative and post-operative period. In 24 patients of the fourth group, the N-terminal fragment of brain natriuretic peptide has significantly decreased on the first day after surgery. In 7 patients of the fourth group, the growth of the N-peptide level was reported, complicated postoperative period, sometimes with fatal outcome, took place in these cases. The level of this marker is associated with the frequency of postoperative complications, reoperations, and its threshold level for determining high-risk group for complications was 5400 pg/ml.&#x0D; Conclusion. The concentration of the N-terminal fragment of brain natriuretic peptide on day 1 after surgical intervention in patients with congenital heart disease can be used to predict the clinical course of postoperative period; the level above 5400 pg/ml is considered to be a risk factor for postoperative complications and reoperations.

The value of N-terminal pro-Brain Natriuretic Peptide in children with severe hand-foot-mouth disease

Objective To explore the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in assessing severity and predicting prognosis in children with severe hand-foot-mouth disease (HFMD). Methods A total of 119 eligible children with severe HFMD admitted in the pediatric intensive care unit were enrolled in this retrospective study from March 2012 to March 2014. According to NT-proBNP level, children were divided into ≤ 500 pg/mL group (n =70) and >500 pg/mL group (n =49) ; whereas according to severity, children were divided into severe-type (n =74) and critical-type (n =45) ; and based on 28 days outcome in children with critical-type HFMD, children were divided into fatal group (n =27) and survival group (n =18). The chi-square test, two-samplet test, rank sum test Pearson or Spearman' s correlation , area under the receiver operating characteristic curve (AUC) were used to analyze119 children with severe hand-foot-mouth disease (HFMD). Results Within 24 hours after admission, NT-proBNP>500 pg /mL group had higher rates of fever, abnormal breathing, abnormal heart rate, abnormal systolic blood pressure, capillary refill time >2 seconds and higher levels of laboratory biomarkers than NT-proBNP ≤ 500 pg/mL group (P <0.05) ; and during hospitalization, the rates of pulmonary edema, pulmonary hemorrhage and death also higher than NT-proBNP ≤ 500 pg/mL group (P <0.05 ). NT-proBNP, BS, WBC were higher in critical-type group than severe-type group (P =0.00) , while the PCIS (pediatric critical illness score) was lower in critical-type group (χ2 =14.70 , P =0.00). NT-proBNP was higher in fatal group than that in survival group (t =-2.60 , P =0.01) , PCIS was lower in fatal group (Z =2.70 , P =0.01) ; and there were no statistically significant differences in BS and WBC between fatal and survival groups (BS : t =-0.60 , P =0.55 ; WBC : t =-0.72 , P =0.48). NT-proBNP, BS and WBC were negatively correlated with PCIS (r values were -0.58 , -0.46, -0.56 , P values were 0.00). The AUCs of NT-proBNP, BS, WBC and PCIS to determine the severity of severe HFMD children were 0.94, 0.80, 0.74, and 0.97, respectively; and to predict 28 days survival in critical-type HFMD were 0.73 , 0.56 , 0.53 , and 0.73 , respectively. Conclusions Higher level of NT-proBNP could prompt cardiopulmonary involvement. NT-proBNP could reflect the severity of illness and served as a sensitive marker in predicting 28-day survival, being better than BS and WBC. Key words: N-terminal pro-brain natriuretic peptide; Severe; Hand-foot-mouth disease; Cardiopulmonary function; Pediatric critical illness score; Blood sugar; White blood cell; Prognosis

Association of aortic stiffness to brain natriuretic peptide in children before and after device closure of patent ductus arteriosus

ObjectivesWe evaluated the influence of device closure for patent ductus arteriosus (PDA) on the aortic stiffness index (ASI) and brain natriuretic peptide (BNP) and their association with cardiac function. Patients and methodsASI and echocardiography assessment before and after treatment (16±9months) in 48 children with PDA (mean age 10±4.5) and 52 control children (mean age 9.7±4.6). BNP level was measured pre-closure for all children, and was measured six months after closure only for children with PDA. ResultsASI was higher in PDA patients than in controls (P<0.001). ASI correlated with age (P<0.05), LVEF% (P<0.01), E/E′ (<0.03), pulmonary artery pressure (P<0.001), and BNP (P<0.001). ASI and BNP significantly decreased after closure (P<0.001). ASI and BNP were independent predictors for post-closure systolic dysfunction (P<0.001and <0.005, respectively). Receiver operating curve (ROC) analysis showed that ASI⩾13.5, BNP level ⩾75pg/ml and basal mean pulmonary artery pressure (PAP)⩾23 were powerful predictors for post-closure systolic function. ConclusionASI is significantly associated with BNP and basal PAP in children with PDA. After device closure, aortic distensibility improved significantly and was associated with significant improvement in both systolic and diastolic functions. ASI can be used for monitoring the course of patients with PDA, and may give opportunities for early intervention.

Diastolic dysfunction and N-terminal pro-brain natriuretic peptide in children with meningococcal sepsis

Diastolic dysfunction and N-terminal pro-brain natriuretic peptide in children with meningococcal sepsis

Release of NT-pro brain natriuretic peptide in children before and after adenotonsillectomy

ObjectivesTo measure serum B-type natriuretic peptide, especially N-terminal segment of its prohormone (NT-proBNP) and pulmonary arterial pressure levels and to determine whether NT-proBNP concentrations correlate with pulmonary arterial pressure levels in children before and after adenotonsillectomy. MethodsTwenty children with adenoid and tonsil hypertrophy and 20 healthy subjects were included in the study. Transthoracic echocardiography was performed in all patients to assess pulmonary artery systolic and diastolic pressure with cardiac dysfunction. The NT-proBNP was analyzed for correlation with pulmonary artery pressure. ResultsOur results showed that prohormone serum concentrations and pulmonary arterial pressures were significantly higher in the study group than in the control group at the preoperative evaluation. A significant decrease was detected among patients after surgery (p<0.05). There was no significant difference between the study and control groups for prohormone serum concentration and pulmonary arterial pressure at the postoperative evaluation (p>0.05). ConclusionWe found increased serum prohormone levels and height pulmonary artery pressures in the children with adenoid and tonsil hypertrophy when comparing with healthy subjects. Our study supported that increased serum prohormone levels and pulmonary artery pressures as a result of adenoid and tonsil hypertrophy are reversible. Pediatric cardiologs and otolaryngologs should keep in mind an increased pulmonary artery pressure during management of children with adenoid and tonsil hypertrophy. Furthermore, Doppler echocardiography may be useful in the monitoring of pulmonary arterial pressure and in the follow-up of surgical outcome of children with adenoid and tonsil hypertrophy.

Antibodies to citrullinated peptide in children with juvenile arthritis.

Antibodies to citrullinated peptide in children with juvenile arthritis.

B-type natriuretic peptide in children with atrial or ventricular septal defect: a cardiac catheterization study

In this study, we investigated the relationship between plasma B-type natriuretic peptide (BNP) levels and hemodynamics from cardiac catheterization in pediatric patients with atrial or ventricular septal defect. A total of 59 patients were studied including 80% of patients had Qp/Qs > 1.5 and 25% of patients had pulmonary hypertension. The mean BNP value and BNP z-score were 10.9 ± 11.2 pg/mL and −0.28 ± 1.7 (−2.85 to 3.29), respectively. There was a statistically significant linear correlation between BNP value and the size of defects (r = 0.303, p = 0.002) and a trend toward to positive correlation between BNP value and Qp/Qs ratio (r = 0.183, p = 0.166) among all patients. To identify patients with a Qp/Qs ratio >1.5, the sensitivity and specificity were 28%, 100% in all patients at a plasma BNP cut-off point of 15 pg/mL. We concluded that a BNP > 15 pg/mL would help identify patients who need further intervention.

Progress in the mechanism of plasma N-terminal pro-brain natriuretic peptide in children with Kawasaki disease

Kawasaki disease ( KD) is an acute febrile systemic vasculitic syndrome. Since there is no specific diagnostic test for KD, the diagnosis is mainly based on the clinical menifetations according to the criterias and excluding of other diseases. Recently the value of plasma brain natriuretic peptide ( BNP) in the diagnosis of KD has been paid more attention gradually. The plasma NT-proBNP level is significantly elevated in KD patients in the acute phase. It is of some specificity and sensitivity, and it may due to the local myocardial inflammation, cytokines and diastolic function of left ventricular. This review summarizes the mechanisms by which the elevated levels of plasma NT-proBNP occur in the acute phase of KD. Key words: Mucocutaneous lymph node syndrome; Peptide fragments; Natriuretie peptide