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[Liver function in acute urinary tract infection]
Insights
Early infantile hyperbilirubinemia in infants warrants screening for urinary tract infections, which can be asymptomatic. Bromosulphalein (BSP) retention in pyelonephritis may indicate disease severity due to bacterial toxins.
Area of Science:
- Pediatrics
- Nephrology
- Hepatology
Context:
- Infantile hyperbilirubinemia (jaundice) can be linked to urinary tract infections (UTIs).
- Pyelonephritis, a kidney infection, may present with or without jaundice in children.
- Gram-negative bacteria in UTIs can have toxic effects on liver function.
Purpose:
- To investigate the association between pyelonephritis and icterus in young infants.
- To evaluate liver function in children with pyelonephritis without hyperbilirubinemia.
- To determine if Bromosulphalein (BSP) retention can indicate disease severity in pyelonephritis.
Summary:
- A study observed pyelonephritis associated with icterus in 26 young infants, suggesting screening for asymptomatic bacteriuria in cases of early infantile hyperbilirubinemia.
- Liver function tests in 21 children with pyelonephritis (without jaundice) revealed pathological BSP retention in 6 infants.
- This BSP retention is hypothesized to result from toxic effects of Gram-negative bacteria, potentially indicating disease severity.
Impact:
- Highlights the importance of searching for UTIs in infants with hyperbilirubinemia.
- Suggests BSP retention as a potential biomarker for pyelonephritis severity.
- Informs clinical practice regarding the diagnosis and management of UTIs and liver dysfunction in pediatric patients.
Abstract:
Association of pyelonephritis with icterus has been observed in 26 young infants. The observations suggest that in the case of early infantile hyperbilirubinaemia it is important to search for urinary tract infection which may remain an asymptomatic bacteriuria. Liver function tests were performed in 21 children aged 1 month to 8 years suffering from pyelonephritis without hyperbilirubinaemia. In 6 infants a pathologic BSP-retention was found, probably due to toxic effects of Gram-negative bacteria. It is concluded that BSP-retention might indicate the severity of the disease.