Usefulness of procalcitonin rapid test for the diagnosis of acute pyelonephritis in children in the emergency department

Nikfar, Roya; Khotaee, Ghamartaj; Ataee, Nematolah; Shams, Salman

doi:10.1111/j.1442-200x.2009.002917.x

Cited by 34 publications

(23 citation statements)

References 18 publications

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“…Previously, the lowest specificity for CRP was detected by Ayazi et al 16 while the highest specificity was reported by Kotoula et al 21 . Specificity of CRP was similar to the other studies of Biggi, 11 Nikfar 15 and Güven et al 17 (68%, 65%…”

supporting

confidence: 74%

“…Although CRP had been reported as a significant biomarker of pyelonephritis in previous studies 9,[11][12][13][14][15] controversy about this data had also been revealed [16][17][18] . The median PCT level in our experience was also higher in children with pyelonephritis, as confirmed by other studies [12][13][14][15] . However, the significance of PCT as a predictor in pyelonephritis was not shown by several studies in children 17,18 .…”

Section: Discussionmentioning

confidence: 96%

“…The sensitivity and specificity of CRP in pyelonephritis has been reported between 64-100% and 4-90%, respectively [11][12][13][14][15][16][17][18][19][20][21] . In the English literature, the lowest sensitivity to predict pyelonephritis for CRP was reported by Biggi et al and the highest sensitivity was reported by Benador et al 11,12 .…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, the lowest and highest sensitivities for PRC were reported as 58% and 100% [12][13][14][15][16][17][18][19][20][21][22] . The lowest sensitivity for PCT to predict pyelonephritis was reported by Gürgöze 13 while the highest sensitivity was reported by Bigot 19 .…”

mentioning

confidence: 99%

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Çocuklarda 99mTc-Dimerkaptosüksinik Asid ile Sintigrafik Görüntü Yapılmaksızın Piyelonefrit ve Sistit Tanısı Ayırt Edilebilir mi?

Kılıçaslan¹,

Noyan²,

Cengız³

et al. 2015

Cukurova Medical Journal

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Purpose: Urinary tract infection is one of the most common infections in childhood. Because of the long term sequelae, differentiation of pyelonephritis from cystitis is important. The aim of this study is to determine the value of biomarkers such as C-reactive protein and procalcitonin and whether preferred to predict pyelonephritis in children without 99mTc-Dimercaptosuccinic Acid scan. Material and Methods: Fifty children aged 3 months to 16 years with a first urinary tract infection were included in this retrospective observational study. The medians, sensitivity, specificity, and cut-off values of serum C -reactive protein and procalcitonin to predict pyelonephritis were determined. Results: Thirty-two (64%) patients were diagnosed with pyelonephritis and 18 (36%) were diagnosed with cystitis. The cut-off value for C -reactive protein was 34 mg/L to predict pyelonephritis, with 69% sensitivity and 61% specificity. The cut-off value for procalcitonin was 0.23 ng/mL to predict pyehlonephritis, with 69% sensitivity and 66% specificity. In combination, these biomarkers were 63% sensitive and 78% specific to predict pyelonephritis. Conclusion: Using a combination of procalcitonin and C-Reactive Protein is preferred to predict pyelonephritis in children, instead of the 99mTc-Dimercaptosuccinic Acid scan. Because of its disadvantages, the 99mTc-Dimercaptosuccinic Acid scan should be avoided in children.

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supporting

confidence: 74%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Çocuklarda 99mTc-Dimerkaptosüksinik Asid ile Sintigrafik Görüntü Yapılmaksızın Piyelonefrit ve Sistit Tanısı Ayırt Edilebilir mi?

Kılıçaslan¹,

Noyan²,

Cengız³

et al. 2015

Cukurova Medical Journal

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“…On the basis of Technetium-99m dimercaptosuccinic acid scintigraphy(DMSA), Nikfar et al found procalcitonin concentration test could also be useful in the diagnosis of APN with 77% and 89% of sensitivity and specificity comparing to 80% and 65% of C-reative protein(CRP) (Nikfar, Khotaee et al 2010). However, DMSA still remains the standard tool for diagnosis of APN (Levitchenko, Lahy et al 2001).…”

Section: Acute Pyelonephritismentioning

confidence: 99%

Urinary Tract Infection in Children

Dh²

2011

Clinical Management of Complicated Urinary Tract Infection

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Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children

Shaikh

Borrell

Evron

et al. 2015

Cochrane Database of Systematic Reviews

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BackgroundIn children with urinary tract infection (UTI), only those with pyelonephritis (and not cystitis) are at risk for developing long-term renal sequelae. If non-invasive biomarkers could accurately di erentiate children with cystitis from children with pyelonephritis, treatment and follow-up could potentially be individualized. ObjectivesThe objectives of this review were to 1) determine whether procalcitonin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) can replace the acute DMSA scan in the diagnostic evaluation of children with UTI; 2) assess the influence of patient and study characteristics on the diagnostic accuracy of these tests, and 3) compare the performance of the three tests to each other. Search methodsWe searched MEDLINE, EMBASE, DARE, Web of Science, and BIOSIS Previews for this review. The reference lists of all included articles and relevant systematic reviews were searched to identify additional studies not found through the electronic search. Selection criteriaWe only considered published studies that evaluated the results of an index test (procalcitonin, CRP, ESR) against the results of an acutephase DMSA scan (conducted within 30 days of the UTI) in children aged 0 to 18 years with a culture-confirmed episode of UTI. The following cuto values were used for the primary analysis: 0.5 ng/mL for procalcitonin, 20 mg/L for CRP and 30 mm/h for ESR. Data collection and analysisTwo authors independently applied the selection criteria to all citations and independently abstracted data. We used the bivariate model to calculate pooled random-e ects pooled sensitivity and specificity values. Main resultsA total of 24 studies met our inclusion criteria. Seventeen studies provided data for the primary analysis: six studies (434 children) included data on procalcitonin, 13 studies (1638 children) included data on CRP, and six studies (1737 children) included data on ESR (some studies had data on more than one test). The summary sensitivity estimates (95% CI) for the procalcitonin, CRP, ESR tests at the aforementioned Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children (Review)

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Usefulness of procalcitonin rapid test for the diagnosis of acute pyelonephritis in children in the emergency department

Abstract: We concluded that a rapid determination of PCT concentration could be useful for the management of children with febrile UTI in the emergency room.

Cited by 34 publications

References 18 publications

Çocuklarda 99mTc-Dimerkaptosüksinik Asid ile Sintigrafik Görüntü Yapılmaksızın Piyelonefrit ve Sistit Tanısı Ayırt Edilebilir mi?

Çocuklarda 99mTc-Dimerkaptosüksinik Asid ile Sintigrafik Görüntü Yapılmaksızın Piyelonefrit ve Sistit Tanısı Ayırt Edilebilir mi?

Urinary Tract Infection in Children

Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children

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