In febrile children for more than five days, serum concentrations of soluble urokinase plasminogen activator receptor fail to identify those with Kawasaki Disease - A Pilot Observational Cohort Study

Alsuwaidi AR, George JA and Narchi H

Published on: 2023-11-28


Aim: To assess, in febrile children, the diagnostic effectiveness of the soluble form of urokinase plasminogen activator receptor (suPAR) to distinguish between Kawasaki disease (KD) and infections, and to also investigate its association with the development of coronary artery aneurysms (CAA) in KD.

Material and Methods: On admission of 17 children with fever lasting ≥ 5 days and lacking suggestive diagnostic signs, serum suPAR concentrations were compared between children later diagnosed with either KD or infections. We also calculated the sensitivity, specificity, Youden index, and generated a receiver operating characteristic (ROC) curve to determine the predictive ability of suPAR for diagnosing KD.

Results: KD was later confirmed in seven children, and febrile infections in 10. There was no significant difference in suPAR levels between these two groups: 5.35 ± 2.76 ng/mL in the former compared to 5.57 ± 1.69 ng/mL in the latter (p=0.84).The optimal cut-off value was ≥ 7.74 ng/mL, correctly classifying 64.7% of the cases, however, with a Youden index of 18.6% and an area under the curve of 60%, suPAR was unable to effectively differentiate between the two groups. Among the seven children with KD, the only child who developed CAA had a suPAR concentration of 4.69 ng/mL, whereas the average level was 5.47 ± 1.04 ng/mL in the others. However, the statistical significance could not be determined.

Conclusion: In febrile children for more than 5 days, serum suPAR concentrations cannot distinguish between KD and infections at hospital admission, nor can they predict the development of CAA in KD.