Delta-neutrophil index: a potential predictor of coronary artery involvement in Kawasaki disease by retrospective analysis

Abstract

DNI is the immature granulocyte fraction provided by a blood cell analyzer, which is determined by subtracting the fraction of mature polymorphonuclear leukocytes from the sum of myeloperoxidase-reactive cells. We aimed to evaluate the role of Delta-neutrophil index (DNI) in cardiac prognosis prediction in children with Kawasaki disease (KD). Medical records of 193 patients were retrospectively reviewed. The values of DNI, white blood cells, erythrocyte sedimentation rate, the percent of polymorphonuclear leucocytes, C-reactive protein, aspartate transaminase, alanine aminotransferase, total bilirubin data of children with KD were analyzed. Also, sex and age of children were compared. The value of DNI was higher in children with cardiac complications [median 0.8 (0–0.26) vs 5.3 (3.55–8.95); P < 0.001]. The ROC curves showed that DNI was a better predictor of cardiac complications than other parameters. The best cutoff value for DNI to predict cardiac complications was 5.55% with sensitivity of 80% and specificity of 82% (AUC 0.883, 95% confidence interval [CI] 0.807–0.959, P < 0.05). DNI could serve as a facile and useful marker to predict cardiac complications in children with KD, as it is included in a routine complete blood count.

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Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; all authors. Drafting the work or revising it critically for important intellectual content; all authors. Final approval of the version to be published; all authors. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved; all authors. All authors take full responsibility for the integrity of the study and the final manuscript. No part of the manuscript has been copied from elsewhere or previously published in whole or in part.

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Correspondence to Eun Jung Cheon.

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All authors declare they have no conflict of interest.

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The Institutional Review Board (IRB) of Konyang University Hospital approved. Approval number: 2019-01-009. Date of approval; 2019. 01.16.

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Lee, S.H., Ko, K.O., Lim, J.W. et al. Delta-neutrophil index: a potential predictor of coronary artery involvement in Kawasaki disease by retrospective analysis. Rheumatol Int 39, 1955–1960 (2019). https://doi.org/10.1007/s00296-019-04448-9

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Keywords

  • Delta-neutrophil index
  • Kawasaki disease
  • Prognosis
  • Coronary aneurysms