To distinguish acute cutaneous mucosal lymph node syndrome from common acute febrile diseases in children by using serum ferritin.

We retrospectively collected the subjects from Changzhou Tumor Hospital Affiliated to Soochow University (Changzhou Fourth People’s Hospital), and the Affiliated Changzhou No.2 People’s Hospital to Nanjing Medical University from 2016 to 2021. There were 185 patients with acute cutaneous mucosal lymph node syndrome, including 100 males and 85 females, aged 1(1, 2) years. 194 patients with other acute febrile diseases in children were enrolled for the study, with 99 males and 95 females, aged 2 (1, 3)years, mainly including bronchopneumonia, upper respiratory tract infection, infant emergency, vesicular angina and suppurative tonsillitis. The white blood cell count and neutrophil count, lymphocyte count, monocyte count, eosinophil count, hemoglobin volume, platelet count, high-sensitivity C-reactive protein, C-reactive protein, erythrocyte sedimentation rate, total bilirubin, total protein, albumin, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine kinase, creatine kinase isozyme, procalcitonin, D-dimer, brain natriuretic peptide, serum ferritin, T cell subsets (CD19, CD3, CD4, CD8) and NK cells were measured and recorded.

The values of white blood cell count, neutrophil count, eosinophil count, platelet count, high-sensitivity C-reactive protein, C-reactive protein, erythrocyte sedimentation rate, total bilirubin, alanine aminotransferase, lactate dehydrogenase, creatine kinase isozyme, procalcitonin, D-dimer, N-terminal pro-B-type natriuretic peptide, serum ferritin, T cell subsets (CD19, CD4, CD8), CD4 / CD8 and NK cells were significantly higher than those of other acute febrile diseases in children (P<0.01), while the values of hemoglobin, total protein, albumin, aspartate aminotransferase, creatine kinase and CD3 were significantly lower than those of other acute febrile diseases in children (P<0.01). The serum ferritin cut-off value of 104.7 ng/L effectively distinguished patients with KD from those with other acute febrile illnesses, with a sensitivity and specificity of 92% and 52.94%, respectively.

The serum ferritin of patients with acute cutaneous mucosal lymph node syndrome is significantly higher than that of other acute febrile diseases in children. The serum ferritin cut-off value of 104.7 ng/L can effectively distinguish patients with KD from those with other acute febrile illnesses.