This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Benador, N.
Right arrow Articles by Girardin, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Benador, N.
Right arrow Articles by Girardin, E.
Related Collections
Right arrow Genitourinary Tract

PEDIATRICS Vol. 102 No. 6 December 1998, pp. 1422-1425

Procalcitonin Is a Marker of Severity of Renal Lesions in Pyelonephritis

Received Oct 21, 1997; accepted Apr 28, 1998.

Nadine Benador*, Claire-Anne Siegrist*, Dominique GendrelDagger , Catherine Greder*, Daivy Benador*, Marcel AssicotDagger , Claude Bohuon§, and Eric Girardin*

From the * Department of Pediatrics, Children's Hospital, Geneva, Switzerland; Dagger  Department of Pediatrics and Laboratory of Microbiology, Hôpital Saint-Vincent-de-Paul, Paris, France; and § Institut Gustave-Roussy, Villejuif, France.

Objective.  In an attempt to differentiate acute pyelonephritis from lower urinary tract infection (UTI), we measured serum procalcitonin levels, a recently described marker of infection. We compared it with other commonly used inflammatory markers and evaluated its ability to predict renal involvement as assessed by dimercaptosuccinic acid (DMSA) scintigraphy.

Methods.  Serum C-reactive protein, leukocyte counts, and procalcitonin levels were measured in 80 children, 1 month to 16 years of age, admitted for suspected pyelonephritis. Renal involvement was assessed by 99mTe-DMSA scintigraphy in the first 5 days after admission. The examination was repeated at least 3 months later if the first result was abnormal.

Results.  In lower UTI, the mean procalcitonin (PCT) was 0.38 µg/L ± 0.19 compared with 5.37 µg/L ± 1.9 in pyelonephritis. In these two groups, respectively, leukocyte counts were 10939/mm3 ± 834 and 17429/mm3 ± 994, and C-reactive protein (CRP) levels were 30.3 mg/L ± 7.6 and 120.8 mg/L ± 8.9. When inflammatory markers were correlated to the severity of the renal lesion as ranked by DMSA scintigraphy, we found a highly significant correlation with plasma levels of PCT, but borderline significance with CRP and none with leukocyte counts. Patients without vesicoureteral reflux had a mean PCT of 5.16 µg/L ± 2.33, which was not significantly different from that in patients with reflux who had a mean PCT of 5.76 µg/L ± 3.49. For the prediction of renal lesions at admission, CRP had a sensitivity of 100% and a specificity of 26.1%. The sensitivity and specificity of PCT were 70.3% and 82.6%, respectively.

Conclusion.  We conclude that serum PCT levels were increased significantly in children with febrile UTI when renal parenchymal involvement (assessed by DMSA scintigraphy) was present and allowed for prediction of patients at risk of severe renal lesions.  Key words:  pyelonephritis, UTI, procalcitonin, C-reactive protein, DMSA scintigraphy.




This article has been cited by other articles:


Home page
 PediatricsHome page
I. Chevalier and M. Gauthier
Procalcitonin and Vesicoureteral Reflux in Children With Urinary Tract Infection
Pediatrics, November 1, 2005; 116(5): 1261 - 1262.
[Full Text] [PDF]

Home page
 PediatricsHome page
S. Leroy, C. Adamsbaum, E. Marc, F. Moulin, J. Raymond, D. Gendrel, G. Breart, and M. Chalumeau
Procalcitonin as a Predictor of Vesicoureteral Reflux in Children With a First Febrile Urinary Tract Infection
Pediatrics, June 1, 2005; 115(6): e706 - e709.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
P. Pecile, E. Miorin, C. Romanello, E. Falleti, F. Valent, F. Giacomuzzi, and A. Tenore
Procalcitonin: A Marker of Severity of Acute Pyelonephritis Among Children
Pediatrics, August 1, 2004; 114(2): e249 - e254.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
F Moulin, J Raymond, M Lorrot, E Marc, J Coste, J-L Iniguez, G Kalifa, C Bohuon, and D Gendrel
Procalcitonin in children admitted to hospital with community acquired pneumonia
Arch. Dis. Child., April 1, 2001; 84(4): 332 - 336.
[Abstract] [Full Text]