Journal
PEDIATRIC RESEARCH
Volume 78, Issue 5, Pages 547-553Publisher
SPRINGERNATURE
DOI: 10.1038/pr.2015.137
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Funding
- David Gordon Louis Daniel Foundation (McLean, Virginia)
- Mario Batali Foundation (New York, New York)
- National Institutes of Health, National Heart, Lung, Blood Institute (Bethesda, Maryland) [HL69413]
- Hartwell Foundation (Memphis, Tennessee)
- Harold Amos Medical Faculty Development Program/Robert Wood Johnson Foundation (Indianapolis, Indiana)
- National Institutes of Health (Bethesda, Maryland) through the NIH Roadmap for Medical Research [U54HL108460]
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BACKGROUND: As Kawasaki disease (KD) shares many clinical features with other more common febrile illnesses and misdiagnosis, leading to a delay in treatment, increases the risk of coronary artery damage, a diagnostic test for KD is urgently needed. We sought to develop a panel of biomarkers that could distinguish between acute KD patients and febrile controls (FC) with sufficient accuracy to be clinically useful. METHODS: Plasma samples were collected from three independent cohorts of FC and acute KD patients who met the American Heart Association definition for KD and presented within the first 10 d of fever. The levels of 88 biomarkers associated with inflammation were assessed by Luminex bead technology. Unsupervised clustering followed by supervised clustering using a Random Forest model was used to find a panel of candidate biomarkers. RESULTS: A panel of biomarkers commonly available in the hospital laboratory (absolute neutrophil count, erythrocyte sedimentation rate, ala nine aminotransferase, gamma-glutamyl transferase, concentrations of alpha-1-antitrypsin, C-reactive protein, and fibrinogen, and platelet count) accurately diagnosed 81 96% of KD patients in a series of three independent cohorts. CONCLUSION: After prospective validation, this eight-biomarker panel may improve the recognition of KD.
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