Urinary Colorimetric Sensor Array and Algorithm to Distinguish Kawasaki Disease from Other Febrile Illnesses

• Published in: PloS one Vol. 11; no. 2; p. e0146733
• Main Authors: Li, Zhen, Tan, Zhou, Hao, Shiying, Jin, Bo, Deng, Xiaohong, Hu, Guang, Liu, Xiaodan, Zhang, Jie, Jin, Hua, Huang, Min, Kanegaye, John T., Tremoulet, Adriana H., Burns, Jane C., Wu, Jianmin, Cohen, Harvey J., Ling, Xuefeng B.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 09.02.2016; Public Library of Science (PLoS)
• Subjects: Acids; Adult; Aged; Algorithms; Biology and Life Sciences; Care and treatment; Chemical compounds; Chemistry; Children; Color; Colorimetry; Colorimetry - instrumentation; Complications; Coronary artery; Data Mining; Decision analysis; Decision Support Systems, Clinical; Demographics; Diagnosis; Diagnosis, Differential; Diagnostic systems; Digital imaging; Digital mapping; Dyes; Emergency medical care; Engineering and Technology; Etiology; Exanthema; Female; Fever; Fever - diagnosis; Gene mapping; Genetic algorithms; Humans; Illnesses; Image reconstruction; Indicators; Infants; Kawasaki disease; Kawasaki syndrome; Laboratories; Libraries; Ligands; Male; Medical diagnosis; Medicine; Medicine and Health Sciences; Middle Aged; Mucocutaneous lymph node syndrome; Mucocutaneous Lymph Node Syndrome - diagnosis; Nitric oxide; Nitrogen dioxide; Patients; Pediatrics; pH effects; Physical Sciences; Research and Analysis Methods; Sensors; Surgery; Urinalysis - instrumentation; Urine; Vasculitis; China; La Jolla California; United States > US; California
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0146733

Kawasaki disease (KD) is an acute pediatric vasculitis of infants and young children with unknown etiology and no specific laboratory-based test to identify. A specific molecular diagnostic test is urgently needed to support the clinical decision of proper medical intervention, preventing subsequent complications of coronary artery aneurysms. We used a simple and low-cost colorimetric sensor array to address the lack of a specific diagnostic test to differentiate KD from febrile control (FC) patients with similar rash/fever illnesses. Demographic and clinical data were prospectively collected for subjects with KD and FCs under standard protocol. After screening using a genetic algorithm, eleven compounds including metalloporphyrins, pH indicators, redox indicators and solvatochromic dye categories, were selected from our chromatic compound library (n = 190) to construct a colorimetric sensor array for diagnosing KD. Quantitative color difference analysis led to a decision-tree-based KD diagnostic algorithm. This KD sensing array allowed the identification of 94% of KD subjects (receiver operating characteristic [ROC] area under the curve [AUC] 0.981) in the training set (33 KD, 33 FC) and 94% of KD subjects (ROC AUC: 0.873) in the testing set (16 KD, 17 FC). Color difference maps reconstructed from the digital images of the sensing compounds demonstrated distinctive patterns differentiating KD from FC patients. The colorimetric sensor array, composed of common used chemical compounds, is an easily accessible, low-cost method to realize the discrimination of subjects with KD from other febrile illness.