PMID- 35388427
OWN - NLM
STAT- MEDLINE
DCOM- 20220704
LR  - 20221207
IS  - 2154-1671 (Electronic)
IS  - 2154-1671 (Linking)
VI  - 12
IP  - 7
DP  - 2022 Jul 1
TI  - NT-proBNP Levels Following IVIG Treatment of Multisystem Inflammatory Syndrome in 
      Children.
PG  - e261-e265
LID - 10.1542/hpeds.2022-006534 [doi]
AB  - BACKGROUND AND OBJECTIVES: N-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. METHODS: This 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. RESULTS: Among 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. CONCLUSIONS: Our 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.
CI  - Copyright (c) 2022 by the American Academy of Pediatrics.
FAU - Schmitz, Anna
AU  - Schmitz A
AD  - Stead Family Department of Pediatrics.
AD  - Carver College of Medicine.
FAU - Wood, Kelly E
AU  - Wood KE
AD  - Stead Family Department of Pediatrics.
AD  - Carver College of Medicine.
FAU - Badheka, Aditya
AU  - Badheka A
AD  - Stead Family Department of Pediatrics.
AD  - Carver College of Medicine.
FAU - Burghardt, Elliot
AU  - Burghardt E
AD  - Carver College of Medicine.
AD  - Department of Biostatistics, College of Public Health.
FAU - Wendt, Linder
AU  - Wendt L
AD  - Institute for Clinical and Translational Science, University of Iowa, Iowa City, 
      Iowa.
FAU - Sharathkumar, Anjali
AU  - Sharathkumar A
AD  - Stead Family Department of Pediatrics.
AD  - Carver College of Medicine.
FAU - Koestner, Bryan
AU  - Koestner B
AD  - Stead Family Department of Pediatrics.
AD  - Carver College of Medicine.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Hosp Pediatr
JT  - Hospital pediatrics
JID - 101585349
RN  - 0 (Biomarkers)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - pediatric multisystem inflammatory disease, COVID-19 related
SB  - IM
MH  - Biomarkers/blood
MH  - *COVID-19/blood
MH  - Child
MH  - Humans
MH  - *Immunoglobulins, Intravenous/therapeutic use
MH  - *Natriuretic Peptide, Brain/blood
MH  - Peptide Fragments
MH  - Retrospective Studies
MH  - *Systemic Inflammatory Response Syndrome/blood/drug therapy
MH  - *COVID-19 Drug Treatment
EDAT- 2022/04/08 06:00
MHDA- 2022/07/06 06:00
CRDT- 2022/04/07 05:31
PHST- 2022/04/08 06:00 [pubmed]
PHST- 2022/07/06 06:00 [medline]
PHST- 2022/04/07 05:31 [entrez]
AID - 186712 [pii]
AID - 10.1542/hpeds.2022-006534 [doi]
PST - ppublish
SO  - Hosp Pediatr. 2022 Jul 1;12(7):e261-e265. doi: 10.1542/hpeds.2022-006534.