Evaluation of diagnostic value of procalcitonin in severity indexes of acute pyelonephritis

Due to the characteristics of the low CRP and WBC count in acute pyelonephritis, Procalcitonin (PCT) measurement can be a useful and practical option in acute pyelonephritis. According to different results in the investigation of the diagnostic value of PCT; the aim of this study was to evaluate the diagnostic value of PCT in differentiation of the lower urinary tract infection from acute pyelonephritis.
All patients with a diagnosis of urinary tract infection in Imam Reza and Sina hospitals were enrolled in this study. Positive urine culture was considered as a urinary tract infection. If urinary tract infection with a pathogen colony more than 105 or more than 104 colonies is marked in person, it was considered as a urinary tract infection. In all patients, leukocyte count, ESR, CRP, and serum PCT was measured. In all patients with febrile urinary tract infection, radioisotope scan was performed. If a parenchymal defect was found in scan, they were considered as acute pyelonephritis. And also, patients without fever and normal radioisotope scan were considered as urinary tract infection. The end prolactin levels were compared according to final diagnosis.
In this study, 100 patients were studied: 47 patients with acute pyelonephritis, 53 cases with cystitis. Mean age of patients in acute pyelonephritis and cystitis did not differed significantly; but its P value was 0.106, which was significantly higher than the cut-off point. Gender also had no significant differences between two groups (P-value=0.948). The mean of Procalcitonin was 6.34%; with the range of 2% - 38%.
No statistically significant differences were found between both groups. But the mean of WBC was higher in acute pyelonephritis than cystitis. ESR levels between bath groups were significantly different and it was significantly higher in patients with acute pyelonephritis. The mean of Procalcitonin in the two groups had no significant difference.