Pediatric Nephrology

, Volume 17, Issue 6, pp 409–412

Procalcitonin as a marker of acute pyelonephritis in infants and children

  • V. Smolkin
  • Ariel Koren
  • Raul Raz
  • Raul Colodner
  • Waheeb Sakran
  • Raphael Halevy
Original Article

Abstract 

In the absence of specific symptomatology in children, the early diagnosis of acute pyelonephritis is a challenge, particularly during infancy. In an attempt to differentiate acute pyelonephritis from lower urinary tract infection (UTI), we measured serum procalcitonin (PCT) levels and compared these with other commonly used inflammatory markers. We evaluated the ability of serum PCT levels to predict renal involvement, as assessed by dimercaptosuccinic acid (DMSA) scintigraphy. Serum C-reactive protein (CRP), leukocyte counts, and PCT levels were measured in 64 children admitted for suspected UTI. Renal parenchymal involvement was assessed by 99mTc-DMSA scintigraphy in the first 7 days after admission. In acute pyelonephritis, the median PCT level was significantly higher than in the lower UTI group (3.41, range 0.36–12.4 μg/l vs. 0.13, range 0.02–2.15 μg/l, P<0.0001). In these two groups, respectively, median CRP levels were 120 (range 62–249 mg/l) and 74.5 (range 14.5–235 mg/l, P=0.012) and leukocyte counts were 15,910/mm3 (range 10,200–26,900) and 14,600/mm3 (range 8,190–26,470, P=0.34). For the prediction of acute pyelonephritis, the sensitivity and specificity of PCT were 94.1% and 89.7%, respectively; CRP had a sensitivity of 100%, but a specificity of 18.5%. We conclude that serum PCT may be an accurate marker for early diagnosis of acute pyelonephritis.

Keywords Procalcitonin C-reactive protein Dimercaptosuccinic acid Pyelonephritis Urinary tract infection 

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Copyright information

© IPNA - International Pediatric Nephrology Association New York, USA 2002

Authors and Affiliations

  • V. Smolkin
    • 1
  • Ariel Koren
    • 1
  • Raul Raz
    • 3
  • Raul Colodner
    • 5
  • Waheeb Sakran
    • 1
  • Raphael Halevy
    • 1
  1. 1.Pediatric Department ’B’, Ha’Emek Medical Center, Afula, Israel e-mail: vlsmolkin@yahoo.com Tel.: +972-4-6494152, Fax: +972-4-6495589Israel
  2. 2.Pediatric Nephrology Unit, Ha’Emek Medical Center, Afula, IsraelIsrael
  3. 3.The Baruch Rappaport School of Medicine, Technion, Israel Institute of Technology, Haifa, IsraelIsrael
  4. 4.Infectious Diseases Unit, Ha’Emek Medical Center, Afula, IsraelIsrael
  5. 5.Microbiology Laboratory, Ha’Emek Medical Center, Afula, IsraelIsrael

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