Objectives: Kawasaki Disease (KD) is an acute vasculitis associated with systemic inflammation. This study aimed to investigate the level and clinical significance of soluble ST2 (sST2) in children with KD. Methods: A retrospective analysis was conducted on 287 pediatric KD patients treated at the Pediatric Cardiology Department of Shengjing Hospital, China Medical University, from November 2021 to December 2022. Patients were stratified into subgroups based on the presence of myocardial damage (MD), coronary artery lesions (CAL), multi-organ involvement (MOD; ≥3 organs) and/or intravenous immunoglobulin-resistant KD (IVIG-R KD). In each group, we analyzed the correlation between sST2 levels and various laboratory parameters, including white blood cell count (WBC), hemoglobin (HB), platelet count (PLT), C-reactive protein (CRP), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), N-terminal pro-brain natriuretic peptide (NT-pro BNP), D-dimer, and albumin (ALB). Results: Patients in the CAL group were significantly younger and predominantly male (p < 0.05). In the MD, CAL, MOD, and IVIG-R KD groups, levels of sST2, CRP, NT-pro BNP, and D-dimer were significantly higher than in their respective comparison groups (p < 0.05). sST2 showed weak positive correlations with WBC, CRP, IL-6, NT-pro BNP, and D-dimer, and weak negative correlations with HB and ALB (p < 0.05). sST2, HB, and IL-6 were identified as independent risk factors for MOD (p < 0.05). sST2 and HB were independent risk factors for IVIG-R KD (p < 0.05). Among acute-phase patients, four cases had sST2 levels > 200 ng/mL—all were classified as IVIG-R KD and MOD; three of these also developed coronary artery aneurysms (CAA). Conclusions: Elevated sST2 levels in the acute phase of KD may serve as a clinical indicator of IVIG-R KD, CAA, MOD, and MD.

Objectives: To investigate the level and clinical significance of soluble growth stimulation expressed gene 2 protein (sST2) in children with Kawasaki Disease (KD). Methods: A retrospective analysis was performed on 287 cases of KD in pediatric cardiology Department of Shengjing Hospital Affiliated to China Medical University from November 2021 to December 2022. They were grouped according to whether there was myocardial damage (MD), coronary artery damage (CAL), ≥3organs involved (MOD), and whether there was IVIG-R KD. In respective groups, the level of sST2 is correlated with WBC, HB, PLT, CRP, IL-6, ESR, NT-pro BNP, D-dimer, and ALB. Results: 1. They were younger and more male in CAL (P< 0.05). 2. In MD, CAL, MOD, and IVIG-R KD groups, the level of sST2, CRP, NT-pro BNP and D-dimer were higher than those negative group respectively (P< 0.05). 3. sST2 was weakly positively correlated with WBC, CRP, IL-6, NT-pro BNP and D-dimer, while weakly negatively correlated with HB and ALB (P< 0.05).4. sST2, HB and IL-6 were independent risk factors for MOD (P< 0.05). 5. sST2 and HB were independent risk factors for IVIG-R KD(P< 0.05). 6. In the acute cases, a totalof 4 cases had sST2 > 200ng/mL, all of which were IVIG-R KD and MOD, and among of them, 3 cases were combine with CAA. Conclusions: The level of sST2 was elevated in the acute phase of KD may indicate IVIG-R KD, CAA, MOD, and MD.