{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T06:14:26Z","timestamp":1696572866409},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,7,1]],"date-time":"2014-07-01T00:00:00Z","timestamp":1404172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the predictive value of various clinical and laboratory parameters on the identification of acute extensive and\/or multifocal renal involvement in children with febrile urinary tract infections (<jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical records of 148 children (median age: 2.4\u00a0months, range: 11\u00a0days\u201324\u00a0months), who were admitted during a 3\u2010year period with a first episode of febrile <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>, were analysed. Acute dimercaptosuccinic acid scintigraphy (DMSA), clinical and laboratory parameters were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy six children (51%) had abnormal findings on the acute DMSA. Of them, 20 had DMSA grade 2, while 56 had grade 3 and 4. Patients with a DMSA grade 3 and 4 were more likely to have shivering (OR 3.4), white blood count (WBC)\u00a0\u2265\u00a018\u00a0000\/<jats:italic>\u03bc<\/jats:italic>L (OR 2.4), absolute neutrophil count (ANC)\u00a0\u2265\u00a09300\/<jats:italic>\u03bc<\/jats:italic>L (OR 4.4), C\u2010reactive protein (CRP)\u00a0\u2265\u00a050\u00a0mg\/L (OR 2.7) and procalcitonin (PCT)\u00a0\u2265\u00a01.64\u00a0ng\/mL (OR diagnostic). There was a significant difference of WBC (p\u00a0=\u00a00.004), ANC, CRP and PCT levels (p\u00a0&lt;\u00a00.001) between children with normal and grade 2 <jats:styled-content style=\"fixed-case\">aDMSA<\/jats:styled-content> versus those with <jats:styled-content style=\"fixed-case\">aDMSA<\/jats:styled-content> grade 3 and 4.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Shivering and elevated inflammatory markers increase the risk of acute extensive and\/or multifocal kidney involvement in children with febrile <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>. Procalcitonin seems to be an excellent marker of the severity of acute parenchymal involvement.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.12706","type":"journal-article","created":{"date-parts":[[2014,5,26]],"date-time":"2014-05-26T14:36:20Z","timestamp":1401114980000},"update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Clinical and laboratory indices of severe renal lesions in children with febrile urinary tract infection"],"prefix":"10.1111","volume":"103","author":[{"given":"AM","family":"Koufadaki","sequence":"first","affiliation":[{"name":"Second Department of Pediatrics University of Athens \u201cP. &amp; A. Kyriakou\u201d Children's Hospital Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KA","family":"Karavanaki","sequence":"additional","affiliation":[{"name":"Second Department of Pediatrics University of Athens \u201cP. &amp; A. 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