Diagnostic performance of serum CK-MB, TNF-α and hs-CRP in children with viral myocarditis

Objective: The purpose of this study was to investigate the diagnostic performance of serum CK-MB, TNF-alpha and hs-CRP in children with viral myocarditis (VMC). Methods: Fifty-six children with confirmed diagnosis of VMC were included in this study. Of the included 56 cases, 25 subjects were in acute and other 31 were in the recovery stage. A contemporaneous control group of 22 children were included for comparison. The serum concentration of CK-MB, TNF-alpha and hs-CRP were examined in both VMC and control groups. Results: The serum concentration of CK-MB, TNF-alpha and hs-CRP were 31.77 +/- 9.48 (UL), 143.11 +/- 23.27 (ng/L) and 8.10 +/- 1.94(mg/L) for acute stage VMC; 12.72 +/- 4.99 (UL), 83.15 +/- 13.35 (ng/L) and 4.07 +/- 1.12 (mg/L) for recovery stage VMC; 8.11 +/- 3.20 (UL), 68.27 +/- 12.55 (ng/L) and 2.56 +/- 1.27 (mg/L) for control group respectively; The serum concentration of CK-MB, TNF-alpha and hs-CRP were significantly different between acute stage VMC, recovery stage VMC and control groups (p<0.05); Significant positive correlation between CK-MB and hs-CRP were found in acute stage VMC (r=0.54, p=0.01) and recovery stage VMC (r=0.37, p=0.04). Using serum CK-MB, TNF-alpha and hs-CRP as the reference, the differential diagnosis sensitivity for acute and recovery stage VMC were 87.10 (70.17-96.37)%, 87.10 (70.17-96.37)% and 77.42 (58.90-90.415)%; The specificity were 92.00 (73.97-99.02)%, 96.00 (79.65-99.90)% and 100.00 (86.28-100.00)% respectively. Conclusion: Serum concentration of CK-MB, TNF-alpha and hs-CRP in children with VMC were significant increased especially in acute stage, which can be used as biomarkers for VMC diagnosis.