Distinctive inflammatory profile between acute focal bacterial nephritis and acute pyelonephritis in children

•Hypercytokinemia was exaggerated in AFBN patients compared with APN patients.•Serum levels of IFN-γ and IL-6 effectively distinguished AFBN from APN.•IFN-γ and IL-6 might play central roles in the pathophysiology of AFBN. Acute focal bacterial nephritis (AFBN) is a severe form of upper urinary trac...

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Published in:Cytokine (Philadelphia, Pa.) Pa.), 2017-11, Vol.99, p.24-29
Main Authors: Mizutani, Makoto, Hasegawa, Shunji, Matsushige, Takeshi, Ohta, Naoki, Kittaka, Setsuaki, Hoshide, Madoka, Kusuda, Takeshi, Takahashi, Kazumasa, Ichihara, Kiyoshi, Ohga, Shouichi
Format: Article
Language:English
Subjects:
Acute Disease
Adolescent
Case-Control Studies
Child
Child, Preschool
Cytokines - blood
Female
Humans
Hypercytokinemia
Infant
Inflammation - blood
Inflammation - complications
Inflammation - pathology
Inflammatory cytokine
Male
Multivariate Analysis
Pyelonephritis - blood
Pyelonephritis - complications
Pyelonephritis - microbiology
Pyelonephritis - pathology
ROC Curve
Sensitivity and Specificity
Upper urinary tract infection
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Summary:•Hypercytokinemia was exaggerated in AFBN patients compared with APN patients.•Serum levels of IFN-γ and IL-6 effectively distinguished AFBN from APN.•IFN-γ and IL-6 might play central roles in the pathophysiology of AFBN. Acute focal bacterial nephritis (AFBN) is a severe form of upper urinary tract infection (UTI) with neurological manifestations and focal renal mass lesions on computed tomography (CT). Prolonged antibiotic therapy may improve the renal outcome, but the early differential diagnosis of AFBN from acute pyelonephritis (APN) is challenging. We searched for effective biomarkers of AFBN based on the pathophysiology of upper UTIs. Of 52 upper UTI cases treated at Yamaguchi University between 2009 and 2016, 38 pediatric patients with AFBN (n=17) or APN (n=21) who underwent ultrasonography and/or CT were enrolled. The clinical data and serum cytokine concentrations were analyzed to differentiate AFBN from APN. AFBN patients tended to be older, and have a higher body temperature, longer febrile period, more frequent neurological symptoms, higher immature neutrophil count, lower lymphocyte count, higher procalcitonin and urine β2-microglobulin levels. AFBN patients showed higher serum levels of IFN-γ, IL-6, IL-10 and soluble TNF-receptor 1 (sTNFR1) (all p
ISSN:1043-4666
1096-0023
DOI:10.1016/j.cyto.2017.06.012