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Table of Contents
Vol. 34, No. 6, 1998
Issue release date: December 1998
Section title: Pediatric Urology
Eur Urol 1998;34:486–491
(DOI:10.1159/000019788)

Combined Use of Urinary α1-Microglobulin and 99mTc DMSA Scintigraphy in the Diagnosis and Follow-Up of Acute Pyelonephritis and Cystitis in Children

Everaert K.a · Raes A.b · Hoebeke P.a · Samijn W.b · Delanghe J.c · Vande Wiele C.d · Vande Walle J.b
Departments of a Urology, b Pediatric Nephrology, c Clinical Chemistry and d Division of Nuclear Medicine, University Hospital of Ghent, Belgium

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Article / Publication Details

First-Page Preview
Abstract of Pediatric Urology

Published online: December 04, 1998
Issue release date: December 1998

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 0302-2838 (Print)
eISSN: 1421-993X (Online)

For additional information: http://www.karger.com/EUR

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 α1-microglobulin (α1-MG) excretion (no false negatives) and if DMSA lesion-negative (cystitis) patients have normal urinary α1-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 α1-MG was determined by immunonephelometry. Results: The urinary α1-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 α1-MG (<10 mg/g). The drop in absolute DMSA uptake correlated significantly (r = 0.758, p < 0.001) with the urinary α1-MG-creatinine ratio. The urinary α1-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 α1-MG excretion and DMSA lesion-negative (cystitis) patients have normal urinary α1-MG excretion.


Article / Publication Details

First-Page Preview
Abstract of Pediatric Urology

Published online: December 04, 1998
Issue release date: December 1998

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 0302-2838 (Print)
eISSN: 1421-993X (Online)

For additional information: http://www.karger.com/EUR


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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