[Procalcitonin, a useful biomarker in pediatric urinary tract infection]

Arch Pediatr. 2013 Jan;20(1):54-62. doi: 10.1016/j.arcped.2012.10.025. Epub 2012 Nov 27.
[Article in French]

Abstract

Urinary tract infections (UTIs) are one of the most common sources of bacterial infections among young febrile children. Accurate diagnosis of acute pyelonephritis (APN) and vesico-ureteral reflux (VUR) are important because of their association with renal scarring, sometimes leading to long-term complications. However, the gold standard examinations are either a DMSA scan for APN and scarring, or cystography for VUR, but both present limitations (feasibility, pain, cost, etc.). Procalcitonin, a reliable marker of bacterial infections, was demonstrated to be a good predictor of renal parenchymal involvement in the acute phase and in late renal scars, as well as of high-grade VUR. These findings need further broad validations and impact studies before being implemented into daily practice. However, procalcitonin may play a role in the complex and still debated picture of which examination should be performed after UTI in children.

MeSH terms

  • Adolescent
  • Bacterial Infections / blood
  • Bacterial Infections / complications
  • Bacterial Infections / diagnosis*
  • Biomarkers / blood
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • Child
  • Evidence-Based Medicine
  • Humans
  • Predictive Value of Tests
  • Protein Precursors / blood*
  • Pyelonephritis / blood
  • Pyelonephritis / diagnosis*
  • Pyelonephritis / microbiology
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Urinary Tract Infections / blood
  • Urinary Tract Infections / diagnosis*
  • Urinary Tract Infections / microbiology
  • Vesico-Ureteral Reflux / blood
  • Vesico-Ureteral Reflux / diagnosis*
  • Vesico-Ureteral Reflux / microbiology

Substances

  • Biomarkers
  • CALCA protein, human
  • Protein Precursors
  • Calcitonin
  • Calcitonin Gene-Related Peptide