Predictive value of clinical indicators in children with community-acquired pneumonia complicated with Kawasaki disease

Abstract

Objective  This study aimed to investigate the predictive value of clinical indicators in community-acquired pneumonia (CAP) complicated with Kawasaki disease (KD).

Methods  A retrospective analysis was conducted on the clinical data of inpatients with KD (39 cases), CAP (40 cases), and CAP complicated with KD (CAPKD, 32 cases) at the Children's Hospital of Chongqing Medical University from February 2021 to October 2022. The clinical indicators examined included serum cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, TNF-α, IFN-γ), White Blood Cell (WBC), Neutrophilic granulocyte percentage(NEU%), blood platelet(PLT), Red Blood Cell (RBC), Hemoglobin(Hb), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), procalcitonin(PCT), alanine aminotransferase(ALT), alkaline phosphatase(ALP), Gamma-glutamyl transferase (γ-GT), Aspartate aminotransferase (AST), albumin(Alb), Lactate dehydrogenase (LDH), globulin(Glb), and Total Protein(TP) in patients with KD, CAP, and CAPKD were compared.

Results  The present findings showed that IL-6 > 55.4pg/mL, IL-10 > 9.15pg/mL, PCT > 0.19ng/mL, and ALT > 22.5 U/L were important predictors of CAPKD. Additionally, Hb > 103.5 g /L, and TP > 63.85 g/L have predictive values for CAP without KD. The authors also observed a positive correlation between PCT and IL-6, IL-10. However, Hb and TP were negatively correlated with IL-6 and IL-10.

Conclusion  From the perspective of cytokine levels, IL-6 > 55.4 pg/mL and IL-10 > 9.15 pg/mL have important predictive values for CAPKD.

Keywords
Community-acquired pneumonia; Kawasaki disease; Cytokines