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Transient pyelonephritic changes on 99m Technetium‐dimercaptosuccinic acid scan for at least five months after infection
Author(s) -
Jakobsson B,
Svensson L
Publication year - 1997
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1997.tb08601.x
Subject(s) - dimercaptosuccinic acid , medicine , cystourethrography , urinary system , urination , gastroenterology , urology , reflux , vesicoureteral reflux , disease
A prospective study was performed on 185 children with symptomatic urinary tract infection (UTI), 130F and 55M, having a median age of 0.9 y (range 0.1–9.8) at the time of UTI. The aim of the study was to find out how the 99m Technetium‐dimercaptosuccinic acid (DMS A) scan should be used to investigate UTI, and to follow the development of renal changes during pyelonephritis into subsequent permanent renal damage. All children were investigated with a DMSA scan within 5 days after admission and after 3.9–53.3 (median 9.2) weeks, and 159 were studied again after approximately 2 y (range 1.5‐3.9 y). They all underwent micturition cystourethrography at the time of the second study. At the time of infection, the DMSA scan was abnormal in 85% of the children, in 58% at the first follow‐up and in 36% at the second follow‐up. An abnormal DMSA scan performed within 20 weeks from infection became normal in 38% of cases on the third study, while only 1/10 abnormal DMSA scans performed more than 20 weeks after infection became normal after 1.5‐3.9 y. Persistent renal changes were more common in children > 4 y of age than in children 1 y of age. Two months after the presenting infection, it was unusual to see a normal DMSA scan in a child with a VUR gr. ≥ 3. The study suggests that DMSA changes after an index UTI may be transient for a longer period of time than has been previously considered. Therefore, in order to detect persistent changes, a DMSA scan should be performed more than 5 months after UTI.