Complement 3 and the prognostic nutritional index distinguish kawasaki disease from other fever illness with a nomogram

Yi Shuang Huang, Xiao Ping Liu, Han Bing Xia, Li Na Cui, Xin Ling Lang, Chun Yi Liu, Wei Dong Huang, Jia Yu Zhang, Xi Liu, Ho Chang Kuo*, Tao Zhou*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

5 Scopus citations


Objective: This study aimed to establish a model to distinguish Kawasaki disease (KD) from other fever illness using the prognostic nutritional index (PNI) and immunological factors. Method: We enrolled a total of 692 patients (including 198 with KD and 494 children with febrile diseases). Of those, 415 patients were selected to be the training group and 277 patients to be the validation group. Laboratory data, including the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the prognostic nutritional index (PNI), and immunological factors, were retrospectively collected for an analysis after admission. We used univariate and multivariate logistic regressions and nomograms for the analysis. Result: Patients with KD showed significantly higher C3 and a lower PNI. After a multivariate logistic regression, the total leukocyte count, PNI, C3, and NLR showed a significance (p < 0.05) and then performed well with the nomogram model. The areas under the ROC in the training group and the validation group were 0.858 and 0.825, respectively. The calibration curves of the two groups for the probability of KD showed a near agreement to the actual probability. Conclusions: Compared with children with febrile diseases, patients with KD showed increased C3 and a decreased nutritional index of the PNI. The nomogram established with these factors could effectively identify KD from febrile illness in children.

Original languageEnglish
Article number825
Issue number9
StatePublished - 09 2021

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • Complement 3
  • Kawasaki disease
  • Neutrophil-to-lymphocyte ratio
  • Nomogram model
  • Platelet-to-lymphocyte ratio
  • Prognostic nutritional index
  • White blood cell


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