Purpose:
Procalcitonin (PCT) is one of acute phase reactants such as C-reactive protein (CRP), and is likely to elevate in systemic inflammation, especially bacterial infection. As we know, the CRP level rise in the patients with high fever including Kawasaki disease (KD) and bacterial infection. So we investigated the clinical usefulness of serum PCT level in Kawasaki disease (KD), which is a systemic inflammation caused by vasculitis.
Method:
From August 2013 to June 2014, a total 336 patients were studied serum PCT level during hospitalization. We enrolled 41 patients of KD, 83 patients with viral infection, and 21 patients with bacterial infection.
Result:
The patients with KD had significantly higher mean age (24.4±18.1 months), mean body weight (12.1±3.9 Kg), and mean duration of fever prior to admission (4.4±1.8 days) than other patients (p<0.05). The serum PCT level, white blood cell (WBC) and platelet count, neutrophil proportion, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were significantly higher in KD patients than viral infection patients (p<0.05). Although not statistically significant, the serum PCT level was lower in KD patients than bacterial infection patients, whereas the CRP was higher in KD patients than bacterial infection patients. No significant difference in serum PCT level was showed between complete KD patients and incomplete KD patients. Also there was no significant difference in serum PCT level between responders to an initial intravenous immunoglobulin treatment and nonresponders.
Conclusion:
Serum PCT level may help to differentiate KD from viral infection, but we did not find a significant difference in PCT level between KD and bacterial infection. And the utility of PCT level as clinical marker in KD may be limited.
Predicting IVIG resistance in UK Kawasaki disease
