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Mean platelet volume in young children with urinary tract infection
I Re Lee1,2, Jae Il Shin1,2, Se Jin Park3
1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Insights
Mean platelet volume (MPV) may indicate inflammation in pediatric urinary tract infections (UTI). While higher MPV levels were observed in acute pyelonephritis (APN), C-reactive protein (CRP) showed superior predictive value for APN diagnosis.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Hematology
Background:
- Urinary tract infections (UTIs) are common in young children.
- The role of mean platelet volume (MPV) as an acute phase reactant in pediatric UTIs is not well-established.
- Distinguishing between acute pyelonephritis (APN) and lower UTI is crucial for appropriate management.
Purpose of the Study:
- To investigate the potential of MPV as an inflammatory marker in pediatric UTIs.
- To compare the diagnostic and predictive value of MPV against established inflammatory markers like C-reactive protein (CRP) in differentiating APN from lower UTI.
Main Methods:
- A retrospective study of 118 children under 2 years old with confirmed UTIs.
- Patients were categorized into APN and lower UTI groups based on dimercaptosuccinic acid (DMSA) scan results.
- Measurements included MPV, platelet distribution width (PDW), platelet count, white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and CRP.
Main Results:
- Significantly higher levels of WBC, ESR, CRP, and MPV were found in the APN group compared to the lower UTI group.
- MPV showed positive correlations with PDW and CRP, and a negative correlation with platelet count.
- Multiple logistic regression identified both CRP and MPV as independent predictors of APN, though CRP demonstrated a higher predictive value based on ROC curve analysis.
Conclusions:
- MPV may serve as a useful inflammatory marker in pediatric UTIs.
- However, MPV's predictive value for diagnosing APN in children is not superior to that of CRP.
- CRP remains a more reliable marker for identifying acute pyelonephritis in this population.
Abstract:
Mean platelet volume (MPV) has not yet been well-established in urinary tract infection (UTI). The purpose of this study was to evaluate the role of MPV as an acute phase reactant in children with UTI. Data from 118 young children (<2 years) with UTI between 2012 and 2013 were grouped as acute pyelonephritis (APN) and lower UTI according to the dimercaptosuccinic acid (DMSA) scan abnormalities. MPV, platelet distribution width (PDW) platelet count, and other infection markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], and C-reactive protein [CRP]) were measured. WBC (P = 0.001), ESR (P = 0.005), CRP (P < 0.001) and MPV levels (P = 0.011) were significantly higher in the APN group than those in the lower UTI group. MPV positively correlated with PDW, CRP and negatively with platelet count. Multiple logistic regression analyses showed that CRP and MPV were independent predictive factors for APN patients. However, the area under the Receiver Operating Characteristic (ROC) curve analysis for MPV was lower than CRP. Our results suggest that MPV can be an inflammatory marker in UTI, but the predictive value of MPV was not superior to CRP in the diagnosis of APN.
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