Abstract
Background Acute focal bacterial nephritis (AFBN) is a severe form of upper urinary tract infection (UTI) with neurological manifestations and focal renal mass lesions on computed tomography (CT). Prolonged antibiotic therapy may improve the renal outcome, but the early differential diagnosis of AFBN from acute pyelonephritis (APN) is challenging. We searched for effective biomarkers of AFBN based on the pathophysiology of upper UTIs. Methods Of 52 upper UTI cases treated at Yamaguchi University between 2009 and 2016, 38 pediatric patients with AFBN (n = 17) or APN (n = 21) who underwent ultrasonography and/or CT were enrolled. The clinical data and serum cytokine concentrations were analyzed to differentiate AFBN from APN. Results AFBN patients tended to be older, and have a higher body temperature, longer febrile period, more frequent neurological symptoms, higher immature neutrophil count, lower lymphocyte count, higher procalcitonin and urine β2-microglobulin levels. AFBN patients showed higher serum levels of IFN-γ, IL-6, IL-10 and soluble TNF-receptor 1 (sTNFR1) (all p < 0.05). Although the cytokine levels were variably correlated among each other, multiple logistic regression analysis revealed that combination of IFN-γ and IL-6 levels were most relevant for distinguishing AFBN from APN. The discriminant power of the logistic equation was 0.86 in terms of the area under the curve by the ROC analysis. Conclusions Circulating 4 out of 7 cytokines in AFBN patients were at higher levels compared with those in APN patients. IFN-γ and IL-6 levels might most effectively distinguish AFBN from APN.
| Original language | English |
|---|---|
| Pages (from-to) | 24-29 |
| Number of pages | 6 |
| Journal | Cytokine |
| Volume | 99 |
| DOIs | |
| Publication status | Published - Nov 2017 |
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All Science Journal Classification (ASJC) codes
- Immunology and Allergy
- Immunology
- Biochemistry
- Hematology
- Molecular Biology
Cite this
Distinctive inflammatory profile between acute focal bacterial nephritis and acute pyelonephritis in children. / Mizutani, Makoto; Hasegawa, Shunji; Matsushige, Takeshi; Ohta, Naoki; Kittaka, Setsuaki; Hoshide, Madoka; Kusuda, Takeshi; Takahashi, Kazumasa; Ichihara, Kiyoshi; Ohga, Shouichi.
In: Cytokine, Vol. 99, 11.2017, p. 24-29.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Distinctive inflammatory profile between acute focal bacterial nephritis and acute pyelonephritis in children
AU - Mizutani, Makoto
AU - Hasegawa, Shunji
AU - Matsushige, Takeshi
AU - Ohta, Naoki
AU - Kittaka, Setsuaki
AU - Hoshide, Madoka
AU - Kusuda, Takeshi
AU - Takahashi, Kazumasa
AU - Ichihara, Kiyoshi
AU - Ohga, Shouichi
PY - 2017/11
Y1 - 2017/11
N2 - Background Acute focal bacterial nephritis (AFBN) is a severe form of upper urinary tract infection (UTI) with neurological manifestations and focal renal mass lesions on computed tomography (CT). Prolonged antibiotic therapy may improve the renal outcome, but the early differential diagnosis of AFBN from acute pyelonephritis (APN) is challenging. We searched for effective biomarkers of AFBN based on the pathophysiology of upper UTIs. Methods Of 52 upper UTI cases treated at Yamaguchi University between 2009 and 2016, 38 pediatric patients with AFBN (n = 17) or APN (n = 21) who underwent ultrasonography and/or CT were enrolled. The clinical data and serum cytokine concentrations were analyzed to differentiate AFBN from APN. Results AFBN patients tended to be older, and have a higher body temperature, longer febrile period, more frequent neurological symptoms, higher immature neutrophil count, lower lymphocyte count, higher procalcitonin and urine β2-microglobulin levels. AFBN patients showed higher serum levels of IFN-γ, IL-6, IL-10 and soluble TNF-receptor 1 (sTNFR1) (all p < 0.05). Although the cytokine levels were variably correlated among each other, multiple logistic regression analysis revealed that combination of IFN-γ and IL-6 levels were most relevant for distinguishing AFBN from APN. The discriminant power of the logistic equation was 0.86 in terms of the area under the curve by the ROC analysis. Conclusions Circulating 4 out of 7 cytokines in AFBN patients were at higher levels compared with those in APN patients. IFN-γ and IL-6 levels might most effectively distinguish AFBN from APN.
AB - Background Acute focal bacterial nephritis (AFBN) is a severe form of upper urinary tract infection (UTI) with neurological manifestations and focal renal mass lesions on computed tomography (CT). Prolonged antibiotic therapy may improve the renal outcome, but the early differential diagnosis of AFBN from acute pyelonephritis (APN) is challenging. We searched for effective biomarkers of AFBN based on the pathophysiology of upper UTIs. Methods Of 52 upper UTI cases treated at Yamaguchi University between 2009 and 2016, 38 pediatric patients with AFBN (n = 17) or APN (n = 21) who underwent ultrasonography and/or CT were enrolled. The clinical data and serum cytokine concentrations were analyzed to differentiate AFBN from APN. Results AFBN patients tended to be older, and have a higher body temperature, longer febrile period, more frequent neurological symptoms, higher immature neutrophil count, lower lymphocyte count, higher procalcitonin and urine β2-microglobulin levels. AFBN patients showed higher serum levels of IFN-γ, IL-6, IL-10 and soluble TNF-receptor 1 (sTNFR1) (all p < 0.05). Although the cytokine levels were variably correlated among each other, multiple logistic regression analysis revealed that combination of IFN-γ and IL-6 levels were most relevant for distinguishing AFBN from APN. The discriminant power of the logistic equation was 0.86 in terms of the area under the curve by the ROC analysis. Conclusions Circulating 4 out of 7 cytokines in AFBN patients were at higher levels compared with those in APN patients. IFN-γ and IL-6 levels might most effectively distinguish AFBN from APN.
UR - http://www.scopus.com/inward/record.url?scp=85021674808&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85021674808&partnerID=8YFLogxK
U2 - 10.1016/j.cyto.2017.06.012
DO - 10.1016/j.cyto.2017.06.012
M3 - Article
C2 - 28683358
AN - SCOPUS:85021674808
VL - 99
SP - 24
EP - 29
JO - Cytokine
JF - Cytokine
SN - 1043-4666
ER -