[Role of DMSA scintigraphy in managing pediatric pyelonephritis].
Pyelonephritis in children may lead to irreversible renal damage and eventually to arterial hypertension and renal insufficiency. Inflammation plays a central role in the pathogenesis of pyelonephritis. Dimercaptosuccinic acid (DMSA) scintigraphy permits detection of acute renal lesions and renal scars with high sensitivity and specificity. In our experience 60% of patients who had acute renal lesions on DMSA scintigraphy during pyelonephritis develop scars. Young age appears to be not a risk factor, as in our experience 70% of children older than 5 years develop scars compared to 40% for children younger than 1 year. In addition, only 40% of patients who develop scars have vesicoureteral reflux. DMSA scintigraphy may provide answers to important clinical questions: what is the optimal length of treatment of pyelonephritis? Is parenteral treatment necessary? What is the best treatment of vesicoureteral reflux? DMSA scintigraphy permits therapeutical decision-making according to the renal involvement in each of our patients.
Unité de néphrologie métabolisme, HUG hôpital des Enfants, Genève, Suisse.
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Girardin
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Benador
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010347:Patient Care Planning; D011704:Pyelonephritis / Q000000981:diagnostic imaging* / Q000209:etiology; D011877:Radionuclide Imaging; D012307:Risk Factors; D019783:Technetium Tc 99m Dimercaptosuccinic Acid
D019783:Technetium Tc 99m Dimercaptosuccinic Acid
Rôle de la scintigraphie au DMSA dans la prise en charge des pyélonéphrites de l'enfant.