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Febrile Urinary Tract Infections in Children: The Role of High Mobility Group Box-1.
Chimenz, Roberto; Chirico, Valeria; Cuppari, Caterina; Sallemi, Alessia; Cardile, Davide; Baldari, Sergio; Ascenti, Giorgio; Monardo, Paolo; Lacquaniti, Antonio.
Afiliación
  • Chimenz R; Pediatric Nephrology and Dialysis Unit, University Hospital "G. Martino", 98124 Messina, Italy.
  • Chirico V; Pediatric Nephrology and Dialysis Unit, University Hospital "G. Martino", 98124 Messina, Italy.
  • Cuppari C; Pediatric Nephrology and Dialysis Unit, University Hospital "G. Martino", 98124 Messina, Italy.
  • Sallemi A; Pediatric Nephrology and Dialysis Unit, University Hospital "G. Martino", 98124 Messina, Italy.
  • Cardile D; Nuclear Medicine Unit, University Hospital "G. Martino", 98124 Messina, Italy.
  • Baldari S; Nuclear Medicine Unit, University Hospital "G. Martino", 98124 Messina, Italy.
  • Ascenti G; Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital "G. Martino", 98124 Messina, Italy.
  • Monardo P; Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy.
  • Lacquaniti A; Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy.
Children (Basel) ; 10(1)2022 Dec 26.
Article en En | MEDLINE | ID: mdl-36670598
BACKGROUND: Differentiating between febrile lower urinary tract infection (LUTI) and acute pyelonephritis (APN) is crucial for prompt clinical management. We investigated whether the high mobility group box-1 (HMGB1) could be a useful biomarker in differentiating between LUTI or APN. METHODS: We enrolled seventy-four pediatric patients with suspected LUTI/APN, according to the positive or negative renal scintigraphy (DMSA) scan. If the first DMSA findings were abnormal, a second DMSA was performed after six months. Voiding cystourethrography ruled out vesicoureteral reflux (VUR). RESULTS: Higher serum (s) HMGB1 levels characterized the APN group when compared to LUTI patients (13.3 (11.8-14.3) versus 5.9 (5.2-6.8) ng/mL, p: 0.02), whereas there were no differences according to urine (u) HMGB1 values. sHMGB1 correlated with C-reactive protein (CRP) levels (ß = 0.47; p: 0.02). Receiver operating characteristic curves identified the best diagnostic profile for detecting APN. sHMGB1 area under the curve was different from CRP (p: 0.01) and white blood cells (p: 0.003). After multivariate analyses, VUR (HR:4.81) and sHMGB1 (HR 1.16; p: 0.006) were independently associated with the risk of renal scarring development. CONCLUSIONS: sHMGB1 could represent a marker to differentiate APN from LUTI. Measurement of sHMGB1 could select children for early intervention or long-term follow-up.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Children (Basel) Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Children (Basel) Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza