بررسي كارآيي تشخيص پروكلسيتونين سرم در كودكان مشكوك به پيلونفريت حاد مراجعه كننده به بيمارستان مفيد در سال 1381

Evaluation of procalcitonin as an indicative factor in children with acute polynephrities in Mofid chlidren hospital, 1381

Background: Urinary tract infection (UTi) is a common problem in infants& children. Infection can spread to the kidneys and causes pyelonphritis which is associated with long term consequences. in the absence of specific symptoms and simple laboratory findings,DMSA renal scintigraphy is the reference method to determine renal damage. According to the previous studies , blood procalcitonin (PCT); a new indicator of bacterial infections may be an accurate marker for diagnosis of acute pyelonephritis. The object of this prospective study was to compare the accuracy of PCT with the other routin diagnosistic tests in an attempt to identify upper ʹs UT1. Materials and methods: This clinical trial study was performed on 50 children with UTI , suspected to acute polynephrities admitted in mofid children hospital, Tehran . Serum PCT levels (BRAHMS PCT), CPR, ESR, WBS and PMN were determined in all children. At days 3-5 DMSA-Scan was performed and the diagnosis was based on the DMSA scan results. Serum PCT levels equal 0.5 ng/ml was considered as normal and higher level as acute pyelonphritis . Results : 50 Children inluded 43 girl(86%) with mean ages 24.9 month and 7 boys (14%) with mean ages 22.4 month were studied.The mean PCT level was 1.63 ng/ml . In 10 children, the PCT level was less than 0.5 nglml. Some evidences on acute polynephritis were found in 47 children by DMSA scan. Sensitivity and positive indicative value of PCT were calculated 83% and 97.5%, respectively Conclusion: There was a significant correlation between plasma levels of PCT and the existance of acute polynephritis. But, more invesigaions with large sample sizes arc suggested to clarify this subject.