The Use of Mean Platelet Volume, Plateletcrit, and N-terminal Brain Natriuretic Peptide as Biomarkers of Coronary Artery Involvement in Atypical Kawasaki Disease

Objective: Coronary artery aneurysm and ectasia develop in approximately 15% to 25% of children with untreated Kawasaki disease (KD). Atypical KD has a higher incidence of coronary artery involvement compared to typical KD. Our aim in this study was to identify new markers to support early diagnosis and prevent complications associated with delayed treatment in atypical KD. Method: The patients' demographic characteristics, presenting complaints, clinical findings, mean platelet volume (MPV), plateletcrit (PCT), and N-terminal brain natriuretic peptide (NT-proBNP) levels were analyzed. Coronary artery abnormalities were evaluated using two-dimensional echocardiography. Results are expressed as mean (+/- standard deviation). Results: Sixty children between the ages of 3 and 96 months who were diagnosed with atypical KD were included. Forty consecutive normal children were included as a control group. NT-proBNP, MPV, and PCT values were 381.7 (+/- 272.7 ) pg/mL, 5.8 (+/- 0.93 ) fL, and 0.266% (+/- 0.9 2%) in the patient group and 48.5 (+/- 28.5 ) pg/mL, 8.29 (+/- 1.12 ) fL, and 0.227% (+/- 0.7 8%) in the control group, respectively (p<0.00 1 for all). In the comparison of atypical KD patients with coronary artery involvement (CAI subgroup) and without (non-CAI subgroup), the NT-proBNP values in these subgroups were 542.9 (+/- 226.8 ) and 171 (+/- 161.7 ) pg/mL (p<0.001), MPV values were 5.8 (+/- 0.77 ) and 6.54 (+/- 0.95 ) fL (p<0.005), and PCT values were 0.264% (+/- 0. 1%) and 0.269% (+/- 0.0 8%), respectively. Conclusion: The simultaneous evaluation of MPV, PCT, and NT-proBNP was useful for the diagnosis of atypical KD. NT-proBNP and MPV can be used as markers of CAI in atypical KD.