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BMC Infectious Diseases

, 16:585

Viral diseases

Abstract

BackgroundSevere hand, foot, and mouth disease HFMD is sometimes associated with serious complications such as acute heart failure that can cause substantial child mortality. N-terminal pro-brain natriuretic peptide NT-proBNP is a sensitive and specific biomarker of congestive heart failure. The aim of this study was to use plasma NT-proBNP levels to establish the severity of childhood HFMD.

MethodsA retrospective study was performed in 128 Chinese patients with severe HFMD and 88 patients with mild HFMD treated between January 2014 and October 2015. Univariate and multiple logistic regression analyses were used to analyze the risk factors for severe HFMD. NT-proBNP levels were analyzed in 128 severe HFMD patients, and the predictive value of NT-proBNP was assessed by receiver operating characteristic analyses.

ResultsMultivariate analysis controlling for several potential confounders showed that enterovirus 71 infection odds ratio OR 19.944, 95 % confidence interval CI 6.492–61.271, peripheral WBC count OR 3.428, 95 % CI 1.186–9.914, fasting glucose OR 19.428, 95 % CI 2.236–168.784, procalcitonin OR 9.084, 95 % CI 3.462–23.837, and NT-proBNP >125 pg-mL OR 16.649, 95 % CI 4.731–58.585 were each associated with the severity of HFMD. The 45 dead severe patients had higher pre-procedural levels of NT-proBNP than the 83 cured severe patients 12776 ± 13115 versus 1435 ± 4201 pg-mL, P < 0.001. An NT-proBNP cutoff value of 982 pg-mL predicted mortality with 87 % sensitivity and 86 % specificity.

ConclusionPlasma NT-pro-BNP level appears to be a useful biological marker for predicting the severity and mortality of HFMD.

KeywordsHand, foot, and mouth disease N-terminal pro-brain natriuretic peptide Disease severity Mortality AbbreviationsBNPBrain-type natriuretic peptide

CIConfidence interval

CKCreatine kinase

CK-MBCreatine kinase isoenzyme-MB

EV71Enterovirus 71

HFMDHand foot, and mouth disease

LDHLactate dehydrogenase

NT-proBNPN-terminal of the prohormone brain natriuretic peptide

OROdds ratio

PCTProcalcitonin

WBCWhite blood cell

Electronic supplementary materialThe online version of this article doi:10.1186-s12879-016-1929-9 contains supplementary material, which is available to authorized users.

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Autor: Hui-Ling Deng - Yu-Feng Zhang - Ya-Ping Li - Yu Zhang - Yan Xie - Jun Wang - Xiao-Yan Wang - Shuang-Suo Dang

Fuente: https://link.springer.com/



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