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[Urinary tract infection and biological markers: C-reactive protein, interleukins and procalcitonin]
1Hôpital Saint-Vincent-de-Paul, Paris, France.
Insights
Serum C-reactive protein (CRP) is a useful marker for pediatric urinary tract infection severity. Procalcitonin shows promise for detecting renal scars, though further research on these biomarkers is needed.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Biomarker Research
Background:
- Urinary tract infections (UTIs) in children can lead to severe complications like renal scarring.
- Accurate biomarkers are crucial for assessing UTI severity and predicting outcomes.
- Current markers like C-reactive protein (CRP) have limitations, including false negatives.
Purpose of the Study:
- To evaluate the prognostic value of serum C-reactive protein (CRP), serum and urinary Interleukin-6 (IL-6), and serum procalcitonin in pediatric UTIs.
- To compare the effectiveness of these biomarkers in identifying children with renal lesions and scarring.
Main Methods:
- Analysis of serum CRP, serum IL-6, urinary IL-6, and serum procalcitonin levels in children with UTIs.
- Correlation of biomarker levels with the presence and severity of renal lesions, assessed by scintigraphy.
Main Results:
- Serum CRP is a generally reliable marker for UTI severity, despite occasional false negatives.
- Urinary IL-6 may offer better prognostic value than serum IL-6, as it is elevated in patients with renal lesions, but can be low in some cases.
- Serum procalcitonin levels correlate with the extent of renal scarring on scintigraphy, with a low false-negative rate (<10%).
Conclusions:
- Serum CRP remains a valuable, though imperfect, marker for pediatric UTI severity.
- Urinary IL-6 and particularly serum procalcitonin show potential as prognostic markers for renal involvement in pediatric UTIs.
- Further studies are warranted to definitively establish the sensitivity and specificity of these biomarkers, especially procalcitonin, for clinical use.
Abstract:
Serum C reactive protein (CRP) remains a good marker of the severity of urinary tract infections in children, despite false negative results. Serum IL-6 is not a better marker; urinary IL-6 might have a better prognostic value as it is higher in patients with renal lesions due to infection, but low values are found in some cases. Serum procalcitonin levels are correlated with the importance of renal scars at scintigraphy, with less than 10% of false negative results. Further studies are needed to confirm the sensitivity and sensibility of these markers, especially for procalcitonin.