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Diagnostic Values of Immature Granulocytes Detected by the Sysmex XN 9000 Hematology Analyzer in Children with

Nuran Cetin1, Evin Kocaturk2, Asli Kavaz Tufan1

  • 1Department of Pediatric Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|July 12, 2024
PubMed

Insights

Immature granulocytes (IGs) can help identify children with febrile urinary tract infections (UTIs), kidney scarring, and severe vesicoureteral reflux (VUR). These easily measured blood markers offer valuable diagnostic insights.

Area of Science:

  • Pediatrics
  • Hematology
  • Infectious Diseases

Background:

  • Immature granulocytes (IGs) are recognized indicators of infection and systemic inflammation.
  • Urinary tract infections (UTIs) are common in children, with febrile UTIs potentially leading to serious complications like renal scarring.
  • Early and accurate diagnosis of UTI severity and complications is crucial for effective management.

Purpose of the Study:

  • To evaluate the diagnostic utility of immature granulocytes (IGs) in identifying children with urinary tract infections (UTIs).
  • To assess the association of IGs with specific UTI classifications (febrile UTI, cystitis) and outcomes (renal scarring, vesicoureteral reflux).

Main Methods:

  • An observational study included 194 children with first-time UTIs (95 febrile UTI, 58 cystitis) and 41 controls.
  • Blood samples were collected before antibiotic treatment and again 2 weeks post-treatment.
  • Immature granulocyte percentage (IG%) and count (IGC) were analyzed and correlated with clinical findings using statistical methods, including Cox regression and logistic regression.

Main Results:

  • Elevated IG% and IGC were observed in children with febrile UTI compared to cystitis and controls (P = 0.000).
  • Post-treatment IGC and IG% were significantly higher in patients with renal scarring (P = 0.012, P = 0.021).
  • IGC and IG% showed significant positive associations with renal scarring (HR: 8.181, P = 0.002; HR: 5.106, P = 0.033) and severe VUR (OR: 22.235, P = 0.025; OR: 15.597, P = 0.038).

Conclusions:

  • Immature granulocyte percentage and count are valuable, easily measurable biomarkers.
  • These markers can aid in predicting febrile UTI, the presence of renal scarring, and severe vesicoureteral reflux in pediatric patients.
  • Routine complete blood count analysis of IGs offers a cost-effective diagnostic approach for UTI complications.

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