Focal bacterial nephritis without pyuria in a boy presenting with high urinary β2-MG and NAG levels

DOI 機関リポジトリ PubMed 被引用文献1件 参考文献9件
  • SEKINE HITOMI
    Department of Pediatrics, Fukushima Medical University School of Medicine
  • KAWASAKI YUKIHIKO
    Department of Pediatrics, Fukushima Medical University School of Medicine
  • OHARA SHINICHIRO
    Department of Pediatrics, Fukushima Medical University School of Medicine
  • SUYAMA KAZUHIDE
    Department of Pediatrics, Fukushima Medical University School of Medicine
  • HOSOYA MITSUAKI
    Department of Pediatrics, Fukushima Medical University School of Medicine

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タイトル別名
  • FOCAL BACTERIAL NEPHRITIS WITHOUT PYURIA IN A BOY PRESENTING WITH HIGH URINARY β<sub>2</sub>-MG AND NAG LEVELS

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Acute focal bacterial nephritis (AFBN) is a localized bacterial infection of the kidney presenting as an inflammatory mass without frank abscess formation. We report a case of acute focal bacterial nephritis without pyuria in a five-month-old boy presenting with high urinary β2-microglobulin (β2-MG) and N-Acetyl-β-(D)-Glucosaminidase (NAG) levels. The infant initially presented with high-grade fever, and plain computed tomography (CT) showed a nearly isodense mass, and contrast-enhanced abdominal CT showed a wedge-shaped hypodense lesion. Enterococcus was detected in the subsequent urine culture. A diagnosis of AFBN was made on the basis of his high inflammatory reaction, contrast-enhanced abdominal CT findings and high urinary β2-MG and NAG levels. He was treated with Ceftriaxone and subsequent improvement in inflammatory reaction and contrast-enhanced CT findings were observed. Voiding cystourethrogram (VCUG) showed a grade V right VUR. This case suggests that urinary β2-MG and NAG levels may be useful additional markers for the diagnosis of AFBN without pyuria.

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