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. 2012 Jul;161(1):116-9.
doi: 10.1016/j.jpeds.2012.01.011. Epub 2012 Feb 7.

Plasma follistatin-like protein 1 is elevated in Kawasaki disease and may predict coronary artery aneurysm formation

Mark Gorelik  1 , David C Wilson, Yona K Cloonan, Stanford T Shulman, Raphael Hirsch
Affiliations

Plasma follistatin-like protein 1 is elevated in Kawasaki disease and may predict coronary artery aneurysm formation

Mark Gorelik et al. J Pediatr. 2012 Jul.

Abstract

Objective: To determine whether plasma levels of follistatin-like protein 1 (FSTL-1), a pro-inflammatory protein produced by mesenchymal tissue, including cardiac myocytes, correlate with the development of Kawasaki disease (KD) and coronary artery aneurysms (CAA).

Study design: FSTL-1 plasma levels were measured serially with enzyme-linked immunosorbent assay in 48 patients with KD at time of diagnosis and, when available, 2 weeks, 6 weeks, and 6 months after onset of disease. These were compared with FSTL-1 plasma levels in 23 control subjects. Data were analyzed with generalized estimating equations.

Results: Plasma FSTL-1 levels were elevated in patients with acute KD compared with control subjects (P = .0086). FSTL-1 levels remained significantly elevated at 2 weeks after disease onset, but returned to control levels by 6 months. Seven patients with CAA had significantly higher FSTL-1 levels at the time of diagnosis than patients in whom aneurysms did not develop (P = .0018). Sensitivity and specificity rates for CAA at a specific FSTL-1 cutoff point (178 ng/mL) were 85% and 71%.

Conclusions: Plasma levels of FSTL-1 are elevated in acute KD and may predict cardiac morbidity in this disease. These results suggest a possible role for FSTL-1 in the formation of CAAs.

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Figures

FIGURE 1
FIGURE 1
FSTL-1 plasma levels in KD. Each bar represents the mean ± SEM. n=number of patients.
FIGURE 2
FIGURE 2
Acute FSTL-1 plasma levels in patients with and without CA and controls. Solid line = median FSTL-1 level, dashed line = mean FSTL-1 level. n=number of patients.
FIGURE 3
FIGURE 3
Receiver Operator Curve analysis shows an area under the curve of 0.8223, (95% CI 0.6863, 0.9583). Sensitivity of 85% and Specificity of 71% corresponded to 178 ng/ml.
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