Differentiation of acute pyelonephritis from other febrile states in children using urinary neutrophil gelatinase-associated lipocalin (uNGAL)
Acute pyelonephritis is a severe disease which is sometimes difficult to recognize based on clinical symptoms and routinely available diagnostic tests, especially in young children. The aim of this study was to assess the diagnostic value of urinary neutrophil gelatinase-associated lipocalin (uNGAL)...
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| Veröffentlicht in: | Clinical chemistry and laboratory medicine 2016-01, Vol.54 (1), p.55-61 |
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| creator | Arambašić, Jadranka Mandić, Sanja Debeljak, Željko Mandić, Dario Horvat, Vesna Šerić, Vatroslav |
| description | Acute pyelonephritis is a severe disease which is sometimes difficult to recognize based on clinical symptoms and routinely available diagnostic tests, especially in young children. The aim of this study was to assess the diagnostic value of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a biomarker of acute pyelonephritis.
In this case-control study we analyzed 134 children (median age 2.5 years) who were admitted to the Pediatric Clinic of University Hospital Centre Osijek, Croatia. Eighty of them had acute pyelonephritis, while 54 children had febrile state of different etiology including cystitis and they represented the control group. uNGAL, white blood cells, C-reactive protein, urinanalysis, urine culture, kidney ultrasound and a dimercaptosuccinic acid scintigraphic scan were done for each child. uNGAL was measured using chemiluminiscent microparticle immunoassay on ARHITECT i1000SR (Abbott Diagnostics, IL, USA).
uNGAL values were significantly higher in children with acute pyelonephritis compared to the control groups (113.6 ng/mL vs. 10.2 ng/mL, p |
| doi_str_mv | 10.1515/cclm-2015-0377 |
| format | Article |
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In this case-control study we analyzed 134 children (median age 2.5 years) who were admitted to the Pediatric Clinic of University Hospital Centre Osijek, Croatia. Eighty of them had acute pyelonephritis, while 54 children had febrile state of different etiology including cystitis and they represented the control group. uNGAL, white blood cells, C-reactive protein, urinanalysis, urine culture, kidney ultrasound and a dimercaptosuccinic acid scintigraphic scan were done for each child. uNGAL was measured using chemiluminiscent microparticle immunoassay on ARHITECT i1000SR (Abbott Diagnostics, IL, USA).
uNGAL values were significantly higher in children with acute pyelonephritis compared to the control groups (113.6 ng/mL vs. 10.2 ng/mL, p<0.001). A receiver operating characteristic curve comparison was done for tested parameters and encouraging results were obtained for uNGAL (AUC=0.952). A cut-off value of 29.4 ng/mL had 92.5% sensitivity and 90.7% specificity. We showed that uNGAL can also serve in differentiating acute pyelonephritis from cystitis (cut-off 38.5 ng/mL), and for differentiation of cystitis from febrile states with etiology other than urinary tract infection (UTI) (cut-off 20.4 ng/mL).
uNGAL can be a useful diagnostic biomarker in acute pyelonephritis in children, but also in differentiating cystitis from febrile states other than UTI.</description><identifier>ISSN: 1434-6621</identifier><identifier>EISSN: 1437-4331</identifier><identifier>DOI: 10.1515/cclm-2015-0377</identifier><identifier>PMID: 26053013</identifier><language>eng</language><publisher>Germany: De Gruyter</publisher><subject>Acute Disease ; acute pyelonephritis ; Acute-Phase Proteins - urine ; Adolescent ; Biomarkers - urine ; Case-Control Studies ; Child ; Child, Preschool ; children ; Cystitis - diagnosis ; Diagnosis, Differential ; Female ; Fever - urine ; Humans ; Infant ; Lipocalin-2 ; Lipocalins - urine ; Male ; Proto-Oncogene Proteins - urine ; Pyelonephritis - diagnosis ; Pyelonephritis - urine ; urinary neutrophil gelatinase-associated lipocalin ; urinary tract infection ; Urinary Tract Infections - diagnosis</subject><ispartof>Clinical chemistry and laboratory medicine, 2016-01, Vol.54 (1), p.55-61</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-7510de710afc4faf2b8622b65f93eed4ddd1523eddbbe6e420581685a6a36fa43</citedby><cites>FETCH-LOGICAL-c347t-7510de710afc4faf2b8622b65f93eed4ddd1523eddbbe6e420581685a6a36fa43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.degruyter.com/document/doi/10.1515/cclm-2015-0377/pdf$$EPDF$$P50$$Gwalterdegruyter$$H</linktopdf><linktohtml>$$Uhttps://www.degruyter.com/document/doi/10.1515/cclm-2015-0377/html$$EHTML$$P50$$Gwalterdegruyter$$H</linktohtml><link.rule.ids>314,780,784,27915,27916,66515,68299</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26053013$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arambašić, Jadranka</creatorcontrib><creatorcontrib>Mandić, Sanja</creatorcontrib><creatorcontrib>Debeljak, Željko</creatorcontrib><creatorcontrib>Mandić, Dario</creatorcontrib><creatorcontrib>Horvat, Vesna</creatorcontrib><creatorcontrib>Šerić, Vatroslav</creatorcontrib><title>Differentiation of acute pyelonephritis from other febrile states in children using urinary neutrophil gelatinase-associated lipocalin (uNGAL)</title><title>Clinical chemistry and laboratory medicine</title><addtitle>Clin Chem Lab Med</addtitle><description>Acute pyelonephritis is a severe disease which is sometimes difficult to recognize based on clinical symptoms and routinely available diagnostic tests, especially in young children. The aim of this study was to assess the diagnostic value of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a biomarker of acute pyelonephritis.
In this case-control study we analyzed 134 children (median age 2.5 years) who were admitted to the Pediatric Clinic of University Hospital Centre Osijek, Croatia. Eighty of them had acute pyelonephritis, while 54 children had febrile state of different etiology including cystitis and they represented the control group. uNGAL, white blood cells, C-reactive protein, urinanalysis, urine culture, kidney ultrasound and a dimercaptosuccinic acid scintigraphic scan were done for each child. uNGAL was measured using chemiluminiscent microparticle immunoassay on ARHITECT i1000SR (Abbott Diagnostics, IL, USA).
uNGAL values were significantly higher in children with acute pyelonephritis compared to the control groups (113.6 ng/mL vs. 10.2 ng/mL, p<0.001). A receiver operating characteristic curve comparison was done for tested parameters and encouraging results were obtained for uNGAL (AUC=0.952). A cut-off value of 29.4 ng/mL had 92.5% sensitivity and 90.7% specificity. We showed that uNGAL can also serve in differentiating acute pyelonephritis from cystitis (cut-off 38.5 ng/mL), and for differentiation of cystitis from febrile states with etiology other than urinary tract infection (UTI) (cut-off 20.4 ng/mL).
uNGAL can be a useful diagnostic biomarker in acute pyelonephritis in children, but also in differentiating cystitis from febrile states other than UTI.</description><subject>Acute Disease</subject><subject>acute pyelonephritis</subject><subject>Acute-Phase Proteins - urine</subject><subject>Adolescent</subject><subject>Biomarkers - urine</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>children</subject><subject>Cystitis - diagnosis</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Fever - urine</subject><subject>Humans</subject><subject>Infant</subject><subject>Lipocalin-2</subject><subject>Lipocalins - urine</subject><subject>Male</subject><subject>Proto-Oncogene Proteins - urine</subject><subject>Pyelonephritis - diagnosis</subject><subject>Pyelonephritis - urine</subject><subject>urinary neutrophil gelatinase-associated lipocalin</subject><subject>urinary tract infection</subject><subject>Urinary Tract Infections - diagnosis</subject><issn>1434-6621</issn><issn>1437-4331</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kT1vFDEQhleIiIRAS4lchmITe_21EVUUIEQ6QQP1ymuP7xx57cUfiu5P8Jvj4wIdlUfyM89o5u26dwRfEk74ldZ-6QdMeI-plC-6M8Ko7Bml5OWfmvVCDOS0e53zA24YZ_JVdzoIzCkm9Kz7_clZCwlCcaq4GFC0SOlaAK178DHAukuuuIxsiguKZQcJWZiT84ByUQUycgHpnfOmSVDNLmxRTS6otEcBaklxbZ9oC775g8rQq5yjbtPAIO_WqJVvhov67e5m8-FNd2KVz_D2-T3vfn75_OP2a7_5fnd_e7PpNWWy9JITbEASrKxmVtlhHsUwzILbawpgmDGG8IGCMfMMAtiA-UjEyJVQVFjF6Hl3cfSuKf6qkMu0uKzBexUg1jwRKfB4PUomG3p5RHWKOSew05rc0tabCJ4OGUyHDKZDBtMhg9bw_tld5wXMP_zv0Rvw8Qg8Kl8gGdimum_F9BBrCm3t_5g5a_nRJ_oZmjg</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Arambašić, Jadranka</creator><creator>Mandić, Sanja</creator><creator>Debeljak, Željko</creator><creator>Mandić, Dario</creator><creator>Horvat, Vesna</creator><creator>Šerić, Vatroslav</creator><general>De Gruyter</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160101</creationdate><title>Differentiation of acute pyelonephritis from other febrile states in children using urinary neutrophil gelatinase-associated lipocalin (uNGAL)</title><author>Arambašić, Jadranka ; Mandić, Sanja ; Debeljak, Željko ; Mandić, Dario ; Horvat, Vesna ; Šerić, Vatroslav</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-7510de710afc4faf2b8622b65f93eed4ddd1523eddbbe6e420581685a6a36fa43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Acute Disease</topic><topic>acute pyelonephritis</topic><topic>Acute-Phase Proteins - urine</topic><topic>Adolescent</topic><topic>Biomarkers - urine</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>children</topic><topic>Cystitis - diagnosis</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Fever - urine</topic><topic>Humans</topic><topic>Infant</topic><topic>Lipocalin-2</topic><topic>Lipocalins - urine</topic><topic>Male</topic><topic>Proto-Oncogene Proteins - urine</topic><topic>Pyelonephritis - diagnosis</topic><topic>Pyelonephritis - urine</topic><topic>urinary neutrophil gelatinase-associated lipocalin</topic><topic>urinary tract infection</topic><topic>Urinary Tract Infections - diagnosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arambašić, Jadranka</creatorcontrib><creatorcontrib>Mandić, Sanja</creatorcontrib><creatorcontrib>Debeljak, Željko</creatorcontrib><creatorcontrib>Mandić, Dario</creatorcontrib><creatorcontrib>Horvat, Vesna</creatorcontrib><creatorcontrib>Šerić, Vatroslav</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical chemistry and laboratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arambašić, Jadranka</au><au>Mandić, Sanja</au><au>Debeljak, Željko</au><au>Mandić, Dario</au><au>Horvat, Vesna</au><au>Šerić, Vatroslav</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differentiation of acute pyelonephritis from other febrile states in children using urinary neutrophil gelatinase-associated lipocalin (uNGAL)</atitle><jtitle>Clinical chemistry and laboratory medicine</jtitle><addtitle>Clin Chem Lab Med</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>54</volume><issue>1</issue><spage>55</spage><epage>61</epage><pages>55-61</pages><issn>1434-6621</issn><eissn>1437-4331</eissn><abstract>Acute pyelonephritis is a severe disease which is sometimes difficult to recognize based on clinical symptoms and routinely available diagnostic tests, especially in young children. The aim of this study was to assess the diagnostic value of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a biomarker of acute pyelonephritis.
In this case-control study we analyzed 134 children (median age 2.5 years) who were admitted to the Pediatric Clinic of University Hospital Centre Osijek, Croatia. Eighty of them had acute pyelonephritis, while 54 children had febrile state of different etiology including cystitis and they represented the control group. uNGAL, white blood cells, C-reactive protein, urinanalysis, urine culture, kidney ultrasound and a dimercaptosuccinic acid scintigraphic scan were done for each child. uNGAL was measured using chemiluminiscent microparticle immunoassay on ARHITECT i1000SR (Abbott Diagnostics, IL, USA).
uNGAL values were significantly higher in children with acute pyelonephritis compared to the control groups (113.6 ng/mL vs. 10.2 ng/mL, p<0.001). A receiver operating characteristic curve comparison was done for tested parameters and encouraging results were obtained for uNGAL (AUC=0.952). A cut-off value of 29.4 ng/mL had 92.5% sensitivity and 90.7% specificity. We showed that uNGAL can also serve in differentiating acute pyelonephritis from cystitis (cut-off 38.5 ng/mL), and for differentiation of cystitis from febrile states with etiology other than urinary tract infection (UTI) (cut-off 20.4 ng/mL).
uNGAL can be a useful diagnostic biomarker in acute pyelonephritis in children, but also in differentiating cystitis from febrile states other than UTI.</abstract><cop>Germany</cop><pub>De Gruyter</pub><pmid>26053013</pmid><doi>10.1515/cclm-2015-0377</doi><tpages>7</tpages></addata></record> |
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| subjects | Acute Disease acute pyelonephritis Acute-Phase Proteins - urine Adolescent Biomarkers - urine Case-Control Studies Child Child, Preschool children Cystitis - diagnosis Diagnosis, Differential Female Fever - urine Humans Infant Lipocalin-2 Lipocalins - urine Male Proto-Oncogene Proteins - urine Pyelonephritis - diagnosis Pyelonephritis - urine urinary neutrophil gelatinase-associated lipocalin urinary tract infection Urinary Tract Infections - diagnosis |
| title | Differentiation of acute pyelonephritis from other febrile states in children using urinary neutrophil gelatinase-associated lipocalin (uNGAL) |
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