Abstract 101: Serum Pro Brain Natriuretic Peptide (pro BNP) Levels In Children With Kawasaki Disease

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Introduction: Brain natriuretic peptide (BNP) is a useful biomarker for diagnosing heart failure in adults and children. ProBNP, the precursor form of BNP has been shown to predict myocardial involvement in acute Kawasaki disease (KD) especially in cases of incomplete KD. As the phenotype of KD in North India is different from that in Japan and North America, this study was carried out to validate the utility of proBNP in North Indian children with KD.

Objectives: To assay the levels of proBNP in North Indian children with KD.

Methodology: Serum pro brain natriuretic peptide (pro BNP and NT-proBNP) levels were estimated in 25 children with Kawasaki disease, both during acute phase and later in convalescence. The levels were similarly assayed in an equal number of age and sex matched controls. The proBNP levels were estimated by an enzyme linked immunosorbent assay (ELISA) using the RayBio Human proBNP ELISA kit which detects both pro BNP and NT-pro BNP.

Results: Pro BNP levels were significantly elevated in children during acute phase of KD (4259±8015 pg/ml) when compared to febrile controls (407±542pg/ml) or to children in convalescent phase of KD (509±1066 pg/ml). Pro BNP levels were also higher in children with coronary abnormalities in acute phase.

Conclusions: In our experience, pro BNP is a useful biomarker for KD especially with regard to myocardial involvement. ProBNP level is markedly elevated during the acute phase in all children with KD. In children with persistent coronary artery abnormalities, the proBNP level remains elevated even during convalescence.

Future impact: ProBNP may be useful marker for children with incomplete forms of KD

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