{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:03:13Z","timestamp":1786118593771,"version":"build-2736575974"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To describe the distribution of laboratory values for nonstandard inflammatory and cardiac biomarkers in otherwise healthy children presenting to the pediatric emergency department (PED) with fever and viral or nonspecific illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Single-center retrospective study of otherwise healthy children 3 months to 20 years presenting to the PED with fever and had a laboratory evaluation for multisystem inflammatory syndrome in children (MIS-C) between April 15, 2020 and January 24, 2022. All patients had NT-pro-b-natriuretic peptide (NT-proBNP) or troponin obtained (as part of an institutional pathway for MIS-C evaluation) during this period. Children with comorbidities, MIS-C, Kawasaki disease, myocarditis, or definitive non-viral illness were excluded. We summarized d-dimer, ferritin, troponin, and NT-proBNP distributions using descriptive statistics. One-way analysis of variance tested for differences among 3 disease categories: non-SARS-CoV-2 viral illness, fever not otherwise specified (NOS), and SARS-CoV-2 infection. Outlier values were identified as three times the interquartile range above the third quartile on box-and-whisker plots.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 134 eligible patients, 50, 65, and 19 were categorized as non-SARS-CoV-2 viral illness, fever NOS, and SARS-CoV-2 positive illness, respectively. Median age was 2 years. Median fever duration was 4 days, with 124\/134 (93%) described as well-appearing and 112\/134 (84%) discharged home. The median values for all biomarkers were within institutional laboratory reference ranges, with all distributions skewed to lower values, and without statistically significant differences between disease categories (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). D-dimer values were above the institutional reference range in 43\/97 (44%), ferritin was above the reference range in 24\/114 (21%), NT-proBNP was above the reference range in 26\/123 (21%), and troponin levels were outside the range in 4\/123 (3%). Thirteen patients had extreme outlier values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Otherwise healthy children presenting to the PED with a fever and viral or nonspecific illnesses may frequently have elevated serum d-dimer, ferritin, and NT-proBNP above institutional reference ranges. Troponin elevation was infrequent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/pec.0000000000003489","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T16:00:22Z","timestamp":1759852822000},"page":"42-47","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Distribution of Nonstandard Inflammatory and Cardiac Biomarker Levels in Children With Fever and Viral or Nonspecific Illness"],"prefix":"10.1097","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5363-8044","authenticated-orcid":false,"given":"Danielle N.","family":"Steinberg","sequence":"first","affiliation":[{"name":"Department of Pediatrics, New York Presbyterian- Columbia, Morgan Stanley Children\u2019s Hospital"},{"name":"Department of Pediatric Emergency Medicine, New York University Langone Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Son H.","family":"McLaren","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Aschheim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, New York Presbyterian- Columbia, Morgan Stanley Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter S.","family":"Dayan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar R.","family":"Lubell","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Columbia University 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