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Combined use of urinary α₁-microglobulin and 99mTc DMSA scintigraphy in the diagnosis and follow-up of acute pyelonephritis and cystitis in children

(1998) EUROPEAN UROLOGY. 34(6). p.486-491
Author
Organization
Abstract
Objectives: In the absence of specific symptomatology in children and neurogenic bladder disease patients, the early diagnosis of acute pyelonephritis is a challenge, The aim of the present study was to determine if dimercaptosuccinic acid (DMSA) lesion-positive (acute pyelonephritis) patients have elevated urinary alpha(1)-microglobulin (alpha(1)-MG) excretion (no false negatives) and if DMSA lesion-negative (cystitis) patients have normal urinary alpha(1)-MG excretion (no false positives), Methods: A selected population of 62 children above 3 months of age with a proven urinary tract infection were administered a DMSA scan, A control scan was performed after the acute phase of the illness, and the diagnosis of pyelonephritis (n = 44) was made retrospectively. The urinary alpha(1)-MG was determined by immunonephelometry. Results: The urinary alpha(1)-MG-creatinine ratio was highly sensitive (98%) and specific (100%) and correlated with the DMSA scintigraphy images, Only 1 of the 44 patients with pyelonephritis and all of the cystitis patients (n = 18) had a normal urinary alpha(1)-MG (<10 mg/g), The drop in absolute DMSA uptake correlated significantly (r = 0,758, p < 0.001) with the urinary alpha(1)MG-creatinine ratio, The urinary alpha(1)-MG-creatinine ratio was significantly higher (p < 0.02) in bilateral than in unilateral pyelonephritis, Conclusion: DMSA lesion-positive (acute pyelonephritis) patients have elevated urinary alpha(1)-MG excretion and DMSA lesion-negative (cystitis) patients have normal urinary alpha(1)-MG excretion.
Keywords
alpha(1)-microglobulin, proteinuria, urinary tract infection, pyelonephritis, SPINAL-CORD INJURY, TRACT INFECTION, RENAL-DISEASE, PROTEIN

Citation

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Chicago
Everaert, Karel, A Raes, Piet Hoebeke, W Samijn, Joris Delanghe, Christophe Van De Wiele, and Johan Vande Walle. 1998. “Combined Use of Urinary Α₁-microglobulin and 99mTc DMSA Scintigraphy in the Diagnosis and Follow-up of Acute Pyelonephritis and Cystitis in Children.” European Urology 34 (6): 486–491.
APA
Everaert, K., Raes, A., Hoebeke, P., Samijn, W., Delanghe, J., Van De Wiele, C., & Vande Walle, J. (1998). Combined use of urinary α₁-microglobulin and 99mTc DMSA scintigraphy in the diagnosis and follow-up of acute pyelonephritis and cystitis in children. EUROPEAN UROLOGY, 34(6), 486–491.
Vancouver
1.
Everaert K, Raes A, Hoebeke P, Samijn W, Delanghe J, Van De Wiele C, et al. Combined use of urinary α₁-microglobulin and 99mTc DMSA scintigraphy in the diagnosis and follow-up of acute pyelonephritis and cystitis in children. EUROPEAN UROLOGY. 1998;34(6):486–91.
MLA
Everaert, Karel, A Raes, Piet Hoebeke, et al. “Combined Use of Urinary Α₁-microglobulin and 99mTc DMSA Scintigraphy in the Diagnosis and Follow-up of Acute Pyelonephritis and Cystitis in Children.” EUROPEAN UROLOGY 34.6 (1998): 486–491. Print.
@article{181113,
  abstract     = {Objectives: In the absence of specific symptomatology in children and neurogenic bladder disease patients, the early diagnosis of acute pyelonephritis is a challenge, The aim of the present study was to determine if dimercaptosuccinic acid (DMSA) lesion-positive (acute pyelonephritis) patients have elevated urinary alpha(1)-microglobulin (alpha(1)-MG) excretion (no false negatives) and if DMSA lesion-negative (cystitis) patients have normal urinary alpha(1)-MG excretion (no false positives),
Methods: A selected population of 62 children above 3 months of age with a proven urinary tract infection were administered a DMSA scan, A control scan was performed after the acute phase of the illness, and the diagnosis of pyelonephritis (n = 44) was made retrospectively. The urinary alpha(1)-MG was determined by immunonephelometry.
Results: The urinary alpha(1)-MG-creatinine ratio was highly sensitive (98\%) and specific (100\%) and correlated with the DMSA scintigraphy images, Only 1 of the 44 patients with pyelonephritis and all of the cystitis patients (n = 18) had a normal urinary alpha(1)-MG ({\textlangle}10 mg/g), The drop in absolute DMSA uptake correlated significantly (r = 0,758, p {\textlangle} 0.001) with the urinary alpha(1)MG-creatinine ratio, The urinary alpha(1)-MG-creatinine ratio was significantly higher (p {\textlangle} 0.02) in bilateral than in unilateral pyelonephritis,
Conclusion: DMSA lesion-positive (acute pyelonephritis) patients have elevated urinary alpha(1)-MG excretion and DMSA lesion-negative (cystitis) patients have normal urinary alpha(1)-MG excretion.},
  author       = {Everaert, Karel and Raes, A and Hoebeke, Piet and Samijn, W and Delanghe, Joris and Van De Wiele, Christophe and Vande Walle, Johan},
  issn         = {0302-2838},
  journal      = {EUROPEAN UROLOGY},
  keyword      = {alpha(1)-microglobulin,proteinuria,urinary tract infection,pyelonephritis,SPINAL-CORD INJURY,TRACT INFECTION,RENAL-DISEASE,PROTEIN},
  language     = {eng},
  number       = {6},
  pages        = {486--491},
  title        = {Combined use of urinary \ensuremath{\alpha}\unmatched{2081}-microglobulin and 99mTc DMSA scintigraphy in the diagnosis and follow-up of acute pyelonephritis and cystitis in children},
  url          = {http://dx.doi.org/10.1159/000019788},
  volume       = {34},
  year         = {1998},
}

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