Open AccessLeucine-rich alpha-2-glycoprotein 1 and angiotensinogen as diagnostic biomarkers for Kawasaki disease
Author(s) -
Masakatsu Yanagimachi,
Saburo Fukuda,
Fumiko Tanaka,
Mari Iwamoto,
Chiho Takao,
Kunihiro Oba,
Naoki Suzuki,
Koji Kiyohara,
Dai Kuranobu,
Norimasa Tada,
Ayako Nagashima,
Taku Ishii,
Yoko Ino,
Yayoi Kimura,
Nobutoshi Nawa,
Takeo Fujiwara,
Takuya Naruto,
Tomohiro Morio,
Shouzaburo Doi,
Masaaki Mori
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0257138
Subject(s) - medicine , odds ratio , kawasaki disease , biomarker , confidence interval , cohort , systemic vasculitis , prospective cohort study , gastroenterology , cohort study , vasculitis , disease , artery , biology , biochemistry
Objective Kawasaki disease (KD) is a systemic vasculitis in childhood that can lead to coronary artery lesions (CALs). Although early diagnosis and treatment is important for preventing KD patients from development of CALs, diagnosis depends on the clinical features of KD. We studied the usefulness of leucine-rich alpha-2-glycoprotein 1 (LRG1) and angiotensinogen (AGT), previously reported as KD-related proteins, for KD diagnosis and estimation of intravenous immunoglobulin (IVIG) efficacy. Methods We undertook a prospective cohort study with patients having two or more KD symptoms in multiple centers in Japan, between July 2017 and February 2019. Results Two hundred forty-two patients were included. In multivariable analysis, one unit increase in LRG1 was associated with higher odds of KD diagnosis (Odds ratio [OR] 1.02 [95% confidence interval (CI) 1.001–1.03]). Double-positivity for AGT (≥ 26 μg/mL) and LRG1 (≥ 123.5 μg/mL) was an independent biomarker for KD diagnosis in both the total cohort and the subgroup of patients with two to four KD symptoms (OR 5.01 [95% CI 1.86–13.50] and 3.71 [95% CI 1.23–11.16], respectively). There was no association between LRG1/AGT and IVIG efficacy. Conclusion Double-positivity for LRG1 and AGT is an biomarker for KD diagnosis, especially useful in diagnosing incomplete KD from non-KD. Future studies with larger cohorts should seek to determine whether LRG1 and AGT are valuable as definitive data referred at the diagnosis of KD and for estimating the risk of CALs.