Clinical Usefulness of Serum Krebs von den Lungen-6 for Detecting Chronic Aspiration in Children with Severe Motor and Intellectual Disabilities

J Pediatr. 2015 Nov;167(5):1136-42. doi: 10.1016/j.jpeds.2015.08.030. Epub 2015 Sep 14.

Abstract

Objective: To determine whether the serum level of Krebs von den Lungen-6 (KL-6), a circulating high-molecular weight glycoprotein and a diagnostic biomarker of interstitial lung diseases, is a clinically useful biomarker for detecting chronic aspiration in children with severe motor and intellectual disabilities (SMIDS).

Study design: Children with SMIDS undergoing videofluorography for assessment of dysphagia were prospectively evaluated. Based on the videofluorography results, the participants were classified into aspiration and non-aspiration groups. Age, sex, white blood cell count, and serum levels of C-reactive protein, lactate dehydrogenase, albumin, and KL-6 were compared between the 2 groups. Binary logistic regression was performed to identify factors independently associated with the presence of aspiration.

Results: A total of 66 patients participated in this study, 37 who were classified as the aspiration group and 29 as the non-aspiration group. The serum KL-6 level in the aspiration group was significantly higher than that in the non-aspiration group (median, 344 U/mL vs 207 U/mL, P < .01). Logistic regression modeling showed that the number of prescribed antiepileptic drugs (OR, 1.978; 95% CI, 1.217, 3.214; P < .01) and serum KL-6 level (OR, 1.012; 95% CI, 1.005, 1.019; P < .01) were independent predictors of aspiration.

Conclusions: The study demonstrated that the KL-6 level is significantly higher in children with SMIDS who aspirate than in those who do not. KL-6 shows promise as a biomarker for chronic lung disease due to aspiration in these children.

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Child
  • Child, Preschool
  • Chronic Disease
  • Female
  • Fluoroscopy / methods
  • Follow-Up Studies
  • Humans
  • Infant
  • Intellectual Disability / blood*
  • Intellectual Disability / diagnosis
  • Male
  • Mucin-1 / blood*
  • Pneumonia, Aspiration / blood*
  • Pneumonia, Aspiration / diagnosis
  • Retrospective Studies
  • Severity of Illness Index

Substances

  • Biomarkers
  • MUC1 protein, human
  • Mucin-1