AST-to-ALT ratio and coronary artery lesions among patients with Kawasaki disease

Cao, Lei; Tang, Yunjia; Gang, Miao; Ma, Jin; Qian, Weiguo; Xu, Qian; Lv, Haitao

doi:10.1007/s12519-021-00479-0

Cited by 6 publications

(5 citation statements)

References 29 publications

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“…Elevated AST and ALT, as well as hypoalbuminaemia, are linked with IVIG resistance and coronary artery aneurysm [105,107]. From a similar angle, it was noted that patients with a high AST: ALT ratio has an increased risk of getting coronary artery lesion in KD [108]. It had been suggested that deranged liver parameters are the possible manifestations of atypical KD, thus signifying the importance of performing liver function tests in patients suspected of KD to assist in making an earlier diagnosis [109].…”

Section: Liver Function Test and Lipid Profilementioning

confidence: 96%

Clinical Manifestations and Laboratory Findings of Kawasaki Disease: Beyond the Classic Diagnostic Features

et al. 2022

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Kawasaki disease (KD) has shown a marked increase in trend over the globe, especially within the last two decades. Kawasaki disease is often seen in the paediatric population below five years old, while it is rare for those who are beyond that age. Up to this date, no exact causes has been identified although KD was found more than half a century ago. The underlying pathogenesis of the disease is still unelucidated, and researchers are trying to unlock the mystery of KD. To further complicate the diagnosis and the prompt management, a specific biomarker for the diagnosis of KD is yet to be discovered, making it hard to differentiate between KD and other diseases with a similar presentation. Nonetheless, since its discovery, clinicians and scientists alike had known more about the different clinical aspects of typical KD. Thus, this article intends to revisit and review the various clinical manifestations and laboratory characteristics of KD in order to guide the diagnosis of KD.

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Section: Liver Function Test and Lipid Profilementioning

confidence: 96%

Clinical Manifestations and Laboratory Findings of Kawasaki Disease: Beyond the Classic Diagnostic Features

et al. 2022

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“…Adult patients with higher baseline AST/ALT levels are more likely to develop fatal cardiovascular disease ( 24 ). Other studies demonstrated that AST/ALT is a risk factor for coronary artery injury at admission ( 25 ). This supports the possible association between AST and a severe inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

Predicting Kawasaki disease shock syndrome in children

Zhao,

Yuan,

Gao

et al. 2024

Front. Immunol.

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BackgroundKawasaki disease shock syndrome (KDSS) is a critical manifestation of Kawasaki disease (KD). In recent years, a logistic regression prediction model has been widely used to predict the occurrence probability of various diseases. This study aimed to investigate the clinical characteristics of children with KD and develop and validate an individualized logistic regression model for predicting KDSS among children with KD.MethodsThe clinical data of children diagnosed with KDSS and hospitalized between January 2021 and December 2023 were retrospectively analyzed. The best predictors were selected by logistic regression and lasso regression analyses. A logistic regression model was built of the training set (n = 162) to predict the occurrence of KDSS. The model prediction was further performed by logistic regression. A receiver operating characteristic curve was used to evaluate the performance of the logistic regression model. We built a nomogram model by visualizing the calibration curve using a 1000 bootstrap resampling program. The model was validated using an independent validation set (n = 68).ResultsIn the univariate analysis, among the 24 variables that differed significantly between the KDSS and KD groups, further logistic and Lasso regression analyses found that five variables were independently related to KDSS: rash, brain natriuretic peptide, serum Na, serum P, and aspartate aminotransferase. A logistic regression model was established of the training set (area under the receiver operating characteristic curve, 0.979; sensitivity=96.2%; specificity=97.2%). The calibration curve showed good consistency between the predicted values of the logistic regression model and the actual observed values in the training and validation sets.ConclusionHere we established a feasible and highly accurate logistic regression model to predict the occurrence of KDSS, which will enable its early identification.

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“…Notably, our study addressed that no statistical difference in PDGF-CC was observed regardless of CAL. Similarly, there are no significant differences in several laboratory parameters (WBC, PLT, HB, N%, ALB, AST, ALT) regardless of CAL, although these are considered predictors of CAL development [ 31 – 33 ]. This result may be due to the small sample size.…”

Section: Discussionmentioning

confidence: 99%

Serum levels of PDGF-CC as a potential biomarker for the diagnosis of Kawasaki disease

Zhang,

Yang,

Liu

et al. 2024

Ital J Pediatr

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Background Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology that predominantly affects children, and no specific diagnostic biomarkers for KD are available. Platelet-derived growth factor CC (PDGF-CC) is a peptide with angiogenic properties that has been amply demonstrated to play a critical role in the cardiovascular system. This study aimed to investigate the serum expression of PDGF-CC in children with KD and to evaluate the ability of PDGF-CC to diagnose KD. Methods A total of 96 subjects, including 59 KD patients, 17 febrile controls (FC), and 20 healthy controls (HC), were enrolled. Serum levels of PDGF-CC were measured via enzyme-linked immunosorbent assay. The associations between PDGF-CC and clinical laboratory parameters were investigated by correlation analysis. The diagnostic performance was assessed by receiver operating characteristic (ROC) curve analysis. Results Serum PDGF-CC levels in the KD group were significantly higher than in the FC and HC groups. Serum PDGF-CC levels in the KD group were positively correlated with white blood cell counts, percentage of neutrophils, IL-2, IL-12p70, TNF-α, and IL-1β levels, and negatively correlated with the percentage of lymphocytes. In the analysis of ROC curves, the area under the curve was 0.796 (95% confidence interval 0.688–0.880; P < 0.0001) for PDGF-CC and increased to 0.900 (95% confidence interval 0.808–0.957; P < 0.0001) in combination with white blood cell counts and C-reactive protein. Conclusions PDGF-CC is a potential biomarker for KD diagnosis, and the combination with white blood cell counts and C-reactive protein can further improve diagnostic performance.

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AST-to-ALT ratio and coronary artery lesions among patients with Kawasaki disease

Cited by 6 publications

References 29 publications

Clinical Manifestations and Laboratory Findings of Kawasaki Disease: Beyond the Classic Diagnostic Features

Clinical Manifestations and Laboratory Findings of Kawasaki Disease: Beyond the Classic Diagnostic Features

Predicting Kawasaki disease shock syndrome in children

Serum levels of PDGF-CC as a potential biomarker for the diagnosis of Kawasaki disease

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