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Int J Infect Dis. 2013 Dec;17(12):e1166-71. doi: 10.1016/j.ijid.2013.06.012. Epub 2013 Aug 8.

Plasma B-type natriuretic peptide study in children with severe enterovirus 71 infection: a pilot study.

Author information

1
Department of Pediatrics, Taichung Veterans General Hospital, 160, Sec. 3, Chung-Kang Road, Taichung 40705, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: sljan@vghtc.gov.tw.

Abstract

OBJECTIVES:

Severe enterovirus 71 (EV71) infections in children can result in acute heart failure. B-type natriuretic peptide (BNP) is a good biomarker of myocardial stress. The purpose of this study was to use plasma BNP for the detection of EV71 infection with cardiac involvement.

METHODS:

Patients with severe EV71 infections and healthy control subjects were studied: group 1 (n=30), normal controls; group 2 (n=20), EV71 infection with central nervous system involvement; and group 3 (n=3), EV71 infection with cardiopulmonary failure. The demographic and laboratory data including plasma BNP levels were analyzed statistically.

RESULTS:

All group 2 patients recovered completely without neurological sequelae, and all group 3 patients survived without cardiac complications. Group 3 patients had higher troponin I, MB fraction of creatine kinase, and BNP levels than patients of the other groups. The median BNP values were <5 pg/ml in group 1, 9.5 pg/ml in group 2, and 238 pg/ml in group 3. Using a BNP cut-off value of 100 pg/ml to identify cases with severe EV71 infection and acute heart failure, the sensitivity and specificity were both 100%.

CONCLUSIONS:

Children with severe EV71 infections have varying degrees of myocardial stress. Plasma BNP would be a sensitive and reliable biomarker for the detection of cardiac involvement in children with severe EV71 infections.

KEYWORDS:

Acute heart failure; B-type natriuretic peptide; Children; Enterovirus 71 infection

PMID:
23932576
DOI:
10.1016/j.ijid.2013.06.012
[Indexed for MEDLINE]
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