Distinctive inflammatory profile between acute focal bacterial nephritis and acute pyelonephritis in children

Makoto Mizutani, Shunji Hasegawa, Takeshi Matsushige, Naoki Ohta, Setsuaki Kittaka, Madoka Hoshide, Takeshi Kusuda, Kazumasa Takahashi, Kiyoshi Ichihara, Shouichi Ohga

Research output: Contribution to journalArticle

5 Citations (Scopus)

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 languageEnglish
Pages (from-to)24-29
Number of pages6
JournalCytokine
Volume99
DOIs
Publication statusPublished - Nov 2017

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Nephritis
Pyelonephritis
Interleukin-6
Cytokines
Tomography
Logistics
Ultrasonography
Pediatrics
Lymphocytes
Tumor Necrosis Factor Receptors
Calcitonin
Biomarkers
Regression analysis
Interleukin-10
Anti-Bacterial Agents
Urinary Tract Infections
Kidney
Lymphocyte Count
Temperature
Neurologic Manifestations

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 journalArticle

Mizutani, M, Hasegawa, S, Matsushige, T, Ohta, N, Kittaka, S, Hoshide, M, Kusuda, T, Takahashi, K, Ichihara, K & Ohga, S 2017, 'Distinctive inflammatory profile between acute focal bacterial nephritis and acute pyelonephritis in children', Cytokine, vol. 99, pp. 24-29. https://doi.org/10.1016/j.cyto.2017.06.012
Mizutani, Makoto ; Hasegawa, Shunji ; Matsushige, Takeshi ; Ohta, Naoki ; Kittaka, Setsuaki ; Hoshide, Madoka ; Kusuda, Takeshi ; Takahashi, Kazumasa ; Ichihara, Kiyoshi ; Ohga, Shouichi. / Distinctive inflammatory profile between acute focal bacterial nephritis and acute pyelonephritis in children. In: Cytokine. 2017 ; Vol. 99. pp. 24-29.
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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.",
author = "Makoto Mizutani and Shunji Hasegawa and Takeshi Matsushige and Naoki Ohta and Setsuaki Kittaka and Madoka Hoshide and Takeshi Kusuda and Kazumasa Takahashi and Kiyoshi Ichihara and Shouichi Ohga",
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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

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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.

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