Journal article
NT-proBNP Levels Following IVIG Treatment of Multisystem Inflammatory Syndrome in Children
Hospital pediatrics, Vol.12(7), pp.e261-e265
07/01/2022
DOI: 10.1542/hpeds.2022-006534
Abstract
BACKGROUND AND OBJECTIVESN-terminal of probrain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) levels are often elevated in multisystem inflammatory syndrome in children (MIS-C) secondary to inflammation, myocardial dysfunction, or increased wall tension. Intravenous immunoglobulin (IVIG), accepted treatment of MIS-C, may transiently increase myocardial tension and contribute to an increase in NT-proBNP. We sought to study the association between pre- and post-IVIG levels of NT-proBNP and CRP and their clinical significance. METHODSThis single-center, retrospective, cohort study included consecutive children, aged ≤21 years, with diagnosis of MIS-C who received IVIG from April 2020 to October 2021. Data collection included clinical characteristics, laboratory tests, management, and outcomes. Study cohort consisted of patients who received IVIG and had NT-proBNP levels available pre- and post-IVIG. RESULTSAmong 35 patients with MIS-C, 30 met inclusion criteria. Twenty-four, 80%, showed elevation in NT-proBNP post-IVIG. The median NT-proBNP level pre-IVIG was 1921 pg/mL (interquartile range 548-3956), significantly lower than the post-IVIG median of 3756 pg/mL (interquartile range 1342-7634)) (P = .0010). The median pre-IVIG CRP level was significantly higher than the post-IVIG level (12 mg/dL vs 8 mg/dL, P = .0006). All but 1 recovered before discharge, and none had signs of worsening cardiac function post-IVIG. In those who recovered, NT-proBNP had normalized by discharge or 1-week follow-up. CONCLUSIONSOur study shows that NT-proBNP levels often transiently increase immediately after IVIG therapy without signs of worsening myocardial function. These values should be interpreted in the context of CRP levels and clinical recovery.
Details
- Title: Subtitle
- NT-proBNP Levels Following IVIG Treatment of Multisystem Inflammatory Syndrome in Children
- Creators
- Anna Schmitz - University of IowaKelly E Wood - University of IowaAditya Badheka - University of IowaElliot Burghardt - University of IowaLinder Wendt - University of IowaAnjali Sharathkumar - University of IowaBryan Koestner - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Hospital pediatrics, Vol.12(7), pp.e261-e265
- DOI
- 10.1542/hpeds.2022-006534
- ISSN
- 2154-1663
- eISSN
- 2154-1671
- Language
- English
- Date published
- 07/01/2022
- Academic Unit
- Hospital Medicine; Stead Family Department of Pediatrics; Critical Care; Hematology/Oncology
- Record Identifier
- 9984354520302771
Metrics
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