Neutrophil-Lymphocyte Ratio for Predicting Coronary Artery Lesions in Children With Kawasaki Disease

Chidambaram, Aakash Chandran; Ramamoorthy, Jaikumar Govindaswamy; Anantharaj, Avinash

doi:10.1007/s13312-023-2836-1

Cited by 4 publications

(1 citation statement)

References 12 publications

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“…The reason may be that neutrophils play a key role in the elicitation of pro-inflammatory responses in vivo ( 20 – 22 ), that lymphocytes play a moderating role in these states, that lymphocyte counts are usually reduced in pro-inflammatory states ( 23 ), and that, consequently, the inverse relationship between neutrophils and lymphocytes in pro-inflammatory states results in a significantly higher NLR. Chidambaram et al ( 24 ) concluded that NLR is an independent predictor of CAL in patients with KD, and an NLR ≥ 2.08 on days 4–6 post-febrile identified children at risk for CALs. In a meta-analysis conducted by Sarejloo et al ( 25 ), which analyzed 6,334 cases of KD from 17 articles, of which 1,328 developed CAA, it was found that patients with coronary artery aneurysms had significantly higher levels of NLR than those of patients without coronary artery aneurysms and that NLR may be useful in monitoring the development of CAA in these patients and may further imply that it mediates the pathogenesis of this CAA in underlying inflammation.…”

Section: Discussionmentioning

confidence: 99%

An early predictive model for Kawasaki disease shock syndrome in children in central China

Wu,

Yin,

Wen

et al. 2024

Front. Cardiovasc. Med.

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IntroductionThis study aims to analyze the clinical features of Kawasaki disease (KD) shock syndrome (KDSS) and explore its early predictors.MethodsA retrospective case–control study was used to analyze KD cases from February 2016 to October 2023 in our hospital. A total of 28 children with KDSS and 307 children who did not develop KDSS were included according to matching factors. Baseline information, clinical manifestations, and laboratory indicators were compared between the two groups. Indicators of differences were analyzed based on univariate analysis; binary logistic regression analysis was used to identify the risk factors for KDSS, and then receiver operating characteristic analysis was performed to establish a predictive score model for KDSS.ResultsElevated neutrophil-to-lymphocyte ratio(NLR) and decreased fibrinogen (FIB) and Na were independent risk factors for KDSS; the scoring of the above risk factors according to the odds ratio value eventually led to the establishment of a new scoring system: NLR ≥ 7.99 (6 points), FIB ≤ 5.415 g/L (1 point), Na ≤ 133.05 mmol/L (3 points), and a total score of ≥3.5 points were high-risk factors for progression to KDSS; otherwise, they were considered to be low-risk factors.ConclusionChildren with KD with NLR ≥ 7.99, FIB ≤ 5.415 g/L, and Na ≤ 133.05 mmol/L, and those with two or more of the above risk factors, are more likely to progress to KDSS, which helps in early clinical diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

An early predictive model for Kawasaki disease shock syndrome in children in central China

Wu,

Yin,

Wen

et al. 2024

Front. Cardiovasc. Med.

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NLRC4 methylation and its response to intravenous immunoglobulin therapy in Kawasaki disease: a case control study

Yu,

Zheng,

Shen

et al. 2024

BMC Pediatr

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Background Kawasaki disease (KD) is a systemic vasculitis accompanied by many systemic physiological and biochemical changes. Elucidating its molecular mechanisms is crucial for diagnosing and developing effective treatments. NLR Family CARD Domain Containing 4 (NLRC4) encodes the key components of inflammasomes that function as pattern recognition receptors. The purpose of this study was to investigate the potential of NLRC4 methylation as a biomarker for KD. Methods In this study, pyrosequencing was utilized to analyze NLRC4 promoter methylation in blood samples from 44 children with initial complete KD and 51 matched healthy controls. Methylation at five CpG sites within the NLRC4 promoter region was evaluated. Results Compared to controls, NLRC4 methylation significantly decreased in KD patients (CpG1: p = 2.93E-06; CpG2: p = 2.35E-05; CpG3: p = 6.46E-06; CpG4: p = 2.47E-06; CpG5: p = 1.26E-05; average methylation: p = 5.42E-06). These changes were significantly reversed after intravenous immunoglobulin (IVIG) treatment. ROC curve analysis demonstrated remarkable diagnostic capability of mean NLRC4 gene methylation for KD (areas under ROC curve = 0.844, sensitivity = 0.75, p = 9.61E-06, 95% confidence intervals were 0.762–0.926 for mean NLRC4 methylation). In addition, NLRC4 promoter methylation was shown to be significantly negatively correlated with the levels of central granulocyte percentage, age, mean haemoglobin quantity and mean erythrocyte volume. Besides, NLRC4 promoter methylation was positively correlated with lymphocyte percentage, lymphocyte absolute value. Conclusions Our work revealed the role of peripheral NLRC4 hypomethylation in KD pathogenesis and IVIG treatment response, could potentially serve as a treatment monitoring biomarker, although its precise functions remain to be elucidated.

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Research Progress of Coronary Artery Lesion in Kawasaki Disease

王

2023

ACM

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Neutrophil-Lymphocyte Ratio for Predicting Coronary Artery Lesions in Children With Kawasaki Disease

Cited by 4 publications

References 12 publications

An early predictive model for Kawasaki disease shock syndrome in children in central China

An early predictive model for Kawasaki disease shock syndrome in children in central China

NLRC4 methylation and its response to intravenous immunoglobulin therapy in Kawasaki disease: a case control study

Research Progress of Coronary Artery Lesion in Kawasaki Disease

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