Usefulness of Spot Urine beta2-microglobulin in Pediatric Acute Pyelonephritis.
- Author:
Hee Sung OH
1
;
Seong Phil BAE
;
Seung Soo KIM
;
Kyeong Bae PARK
Author Information
1. Department of Pediatrics, Soonchunhyang University College of Medicine, Cheonan, Korea. c95985@schmc.ac.kr
- Publication Type:Original Article
- Keywords:
Beta 2-microglobulin;
Urinary tract infections;
Acute pyelonephritis;
Pediatrics
- MeSH:
beta 2-Microglobulin;
Blood Sedimentation;
C-Reactive Protein;
Child;
Humans;
Leukocyte Count;
Pediatrics;
Pyelonephritis;
Sensitivity and Specificity;
Technetium Tc 99m Dimercaptosuccinic Acid;
Urinary Tract Infections
- From:Soonchunhyang Medical Science
2012;18(2):91-94
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: It is difficult to make a distinction between acute pyelonephritis and lower urinary tract infection due to nonspecific clinical symptoms and laboratory findings. We measured the spot urine beta2-microglobulin in children with urinary tract infection (UTI) to distinguish between acute pyelonephritis and lower UTI. We compared the accuracy of urine beta2-microglobulin measurement with other inflammatory markers. METHODS: We studied 83 children (mean, 86+/-44.9 months) who suspected of having UTI. Leukocyte counts, erythrocyte sedimentation rates (ESR) and C-reactive protein (CRP), beta2-microglobulin were measured. Renal parenchymal involvement was evaluated by 99mTc dimercaptosuccinic acid scintigraphy in the first 7 days after admission. beta2-microglobulin was measured by radioimmunoassay. RESULTS: Urine beta2-microglobulin values were correlated with the presence of renal defects in children with UTI (n=22) (0.98+/-0.24 microg/mL, P<0.05). Using a cutoff of 0.4 microg/mL for spot urine beta2-microglobulin and 20 mm/hr for ESR, 2.6 mg/L for CRP, sensitivity and specificity between UTI with and without renal involvement were 78.7% and 90.1% for spot urine beta2-microglobulin, 77.2% and 90.1% for spot urine beta2-microglobulin/creatinine (Cr), 77.2%, 68.8% for ESR, 86.3%, 68.8% for CRP, respectively. Positive and negative predictive values were 72.7%, 90.1% for spot urine beta2-microglobulin, 73.9% and 91.6% for spot urine beta2-microglobulin/Cr, and 57.5%, 94% for CRP, respectively. CONCLUSION: In febrile UTI, spot urine beta2-microglobulin and beta2-microglobulin/Cr values were more specific than CRP, ESR, and leukocyte count for determine the renal defects.
