Renal parenchymal changes in children with acute pyelonephritis using DMSA scan and the relationship with certain biologic factors

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Main Authors: Ataei N, Safaian B, Madani A, Esfahani ST, Ataei F
Format: Article
Language:fas
Published: Tehran University of Medical Sciences 2009-05-01
Series:Tehran University Medical Journal
Subjects:
Online Access:http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/13596.pdf&manuscript_id=13596
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author Ataei N
Safaian B
Madani A
Esfahani ST
Ataei F
author_facet Ataei N
Safaian B
Madani A
Esfahani ST
Ataei F
author_sort Ataei N
collection DOAJ
description "n Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Early diagnosis of renal parenchymal involvement in children with acute pyelonephritis (APN) using isotope scan and early treatment may decrease or prevent development of renal parenchymal lesions. We designed this study to assess the diagnostic value of certain biologic parameters in children with first- episode of acute pyelonephritis (APN) documented by 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy.   "n"n Methods: We compared the laboratory findings of leukocyte count, erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) levels with the results of the DMSA scans obtained within three days of admission. One hundred-two children (93 girls and 9 boys aged 1 month-12 years (mean 2.85±2.92 years) were enrolled in the study. Of these patients, 203 renal units, were investigated using scintigraphy. Voiding cystourethrography (VCUG) was performed in 98 children (195 renal unit) when urine culture became negative. "n"n Results: In all children one or both of kidneys had parenchymal involvement on scintigraphy. Changes on the DMSA scan were found in 178(88%) renal units during the acute phase. The extent of changes in DMSA scan were mild in 113/178(55.7%) renal units, moderate in 40/178(19.7%) and severe in 25/178(12.3%). When inflammatory markers were correlated with the development of the severe renal lesions, as assessed with DMSA scan, a highly significant correlation with both ESR (p=0.007) and leukocyte counts (p=0.02) were found. "n"n Conclusions: We conclude that the incidence of renal parenchymal involvement in Iranian children with APN is very high. Although increased ESR and leucocytosis may be valuable markers for determination of severe renal parenchymal involvement, but these parameters and also CRP, were inadequate in distinguishing mild to moderate renal parenchymal involvement.
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spelling doaj.art-ad6afdd113ae4f4381c7aa8fc59b956c2022-12-21T20:37:20ZfasTehran University of Medical SciencesTehran University Medical Journal1683-17641735-73222009-05-01672125131Renal parenchymal changes in children with acute pyelonephritis using DMSA scan and the relationship with certain biologic factorsAtaei NSafaian BMadani AEsfahani STAtaei F"n Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Early diagnosis of renal parenchymal involvement in children with acute pyelonephritis (APN) using isotope scan and early treatment may decrease or prevent development of renal parenchymal lesions. We designed this study to assess the diagnostic value of certain biologic parameters in children with first- episode of acute pyelonephritis (APN) documented by 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy.   "n"n Methods: We compared the laboratory findings of leukocyte count, erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) levels with the results of the DMSA scans obtained within three days of admission. One hundred-two children (93 girls and 9 boys aged 1 month-12 years (mean 2.85±2.92 years) were enrolled in the study. Of these patients, 203 renal units, were investigated using scintigraphy. Voiding cystourethrography (VCUG) was performed in 98 children (195 renal unit) when urine culture became negative. "n"n Results: In all children one or both of kidneys had parenchymal involvement on scintigraphy. Changes on the DMSA scan were found in 178(88%) renal units during the acute phase. The extent of changes in DMSA scan were mild in 113/178(55.7%) renal units, moderate in 40/178(19.7%) and severe in 25/178(12.3%). When inflammatory markers were correlated with the development of the severe renal lesions, as assessed with DMSA scan, a highly significant correlation with both ESR (p=0.007) and leukocyte counts (p=0.02) were found. "n"n Conclusions: We conclude that the incidence of renal parenchymal involvement in Iranian children with APN is very high. Although increased ESR and leucocytosis may be valuable markers for determination of severe renal parenchymal involvement, but these parameters and also CRP, were inadequate in distinguishing mild to moderate renal parenchymal involvement.http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/13596.pdf&manuscript_id=13596Acute pyelonephritischildrenrenal scandimercaptosuccinic acidleucocytosiserythrocyte sedimentation rateC- reactive protein
spellingShingle Ataei N
Safaian B
Madani A
Esfahani ST
Ataei F
Renal parenchymal changes in children with acute pyelonephritis using DMSA scan and the relationship with certain biologic factors
Tehran University Medical Journal
Acute pyelonephritis
children
renal scan
dimercaptosuccinic acid
leucocytosis
erythrocyte sedimentation rate
C- reactive protein
title Renal parenchymal changes in children with acute pyelonephritis using DMSA scan and the relationship with certain biologic factors
title_full Renal parenchymal changes in children with acute pyelonephritis using DMSA scan and the relationship with certain biologic factors
title_fullStr Renal parenchymal changes in children with acute pyelonephritis using DMSA scan and the relationship with certain biologic factors
title_full_unstemmed Renal parenchymal changes in children with acute pyelonephritis using DMSA scan and the relationship with certain biologic factors
title_short Renal parenchymal changes in children with acute pyelonephritis using DMSA scan and the relationship with certain biologic factors
title_sort renal parenchymal changes in children with acute pyelonephritis using dmsa scan and the relationship with certain biologic factors
topic Acute pyelonephritis
children
renal scan
dimercaptosuccinic acid
leucocytosis
erythrocyte sedimentation rate
C- reactive protein
url http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/13596.pdf&manuscript_id=13596
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AT madania renalparenchymalchangesinchildrenwithacutepyelonephritisusingdmsascanandtherelationshipwithcertainbiologicfactors
AT esfahanist renalparenchymalchangesinchildrenwithacutepyelonephritisusingdmsascanandtherelationshipwithcertainbiologicfactors
AT ataeif renalparenchymalchangesinchildrenwithacutepyelonephritisusingdmsascanandtherelationshipwithcertainbiologicfactors