PENTRAXIN 3 is the Best Biomarker of Kawasaki Disease: Predictor of IVIG Non-Responder and Coronary Artery Lesion and Sequellae - EAP 2019 Congress and MasterCourse Porto Palacio Hotel

Toshiyuki Kitoh ² Tsuyoshi Ohara ² Taichiro Muto ¹ Akihisa Okumura ¹ Yusuke Koizumi ³ Yuka Yamagishi ³ Hiroshige Mikamo ³ Reizo Baba ⁴ Kenji Daigo ⁵ Takao Hamakubo ⁵

¹Department of Pediatrics, Aichi Medical University, Japan
²Department of Pediatric Pharmacology, Aichi Gakuin University, School of Pharmacy, Japan
³Department of Clinical Infectious Diseases, Aichi Medical University, Japan
⁴College of Life and Health Sciences, Chubu University, Japan
⁵Laboratory for protein-protein interaction research, The Institute for Advanced Medical Sciences,, Nippon Medical School, Japan

Kawasaki disease (KD) is a disease of unknown cause whose main symptom is systemic vasculitis due to immune reaction frequently seen in children. The patients rarely develop fatal episodes, coronary artery aneurysm even after established IVIg treatment. Useful biomarkers are required for accurate treatment. From January 2013 to March 2015, all patients with Kawasaki Disease admitted to Pediatrics at Aichi Medical University Hospital were requested consents and obtained plasma was saved before IVIG administration. We examined the correlation between plasma values of PTX3, sCD24-ST (Presepsin) and NT-proBNP and acute coronary artery lesion (CAL) and coronary sequelae in KD. We also examined the IVIG dose number correlated with the severity to measure the predictive ability of the test value. Total 97 cases were registered. 22 case of incomplete KD were excluded from PTX3 analysis. 75 case of complete KD were concluded for statistical analyses. Of the 75 patients with KD, three had CAL and the rest 72 cases did not have (non-CAL group). These were confirmed by echocardiography. Statistically significant difference was seen only in PTX3 among the correlation with coronary lesion acute phase disorder, coronary artery sequelae. 1) When the cutoff value was set at 19.1 ng/ml of PTX3, the specificity was 63.03, and the sensitivity was 72.73, and the likelihood ratio was 19.1 in acute phase CAL. When the cutoff value was set at 68.85 ng/ml of PTX3, specificity 98.21, sensitivity 100, and its likelihood ratio was 56 in coronary artery sequelae. 2) The statistical correlation with PTX only IVIg doses was observed. The r values (correlation coefficients) of PTX3, Presepsin, and NT-proBNP were 0.5398, 0.01893, and 0.05664,respectively.In this cohort, Kobayashi’s Score (KS) was also checked. ROC of IVIG response and KS AUC 0.5188 95%, confidence interval [0.3288 to 0.7088], P value 0.8366 IVIG response and PTX3 AUC 0.907995%, confidence interval [0.8275 to 0.9883], P value