Evaluation of Dimercaptosuccinic Acid Scan (DMSA) findings and it’s correlation with clinical and paraclinical parameters in children with pyelonephritis

Background and Aims: Urinary tract infections (UTIs) are among the most common infections in children, with the potential to cause permanent renal damage.Technetium-99m-DMSA scanning is considered the gold standard for the diagnosis of pyelonephritis.The present study aimed to assess DMSA scan findings and investigate their correlation with clinical and paraclinical parameters in children diagnosed with pyelonephritis. Materials and Methods:This descriptive-analytical study was conducted on 109 children aged between 6 months and 12 years who were hospitalized with a diagnosis of pyelonephritis at Shahid Motahari Hospital in Urmia, Iran, from September 2023 to May 2024.Demographic characteristics, clinical symptoms, laboratory findings white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and DMSA scan results were collected and analyzed.Statistical analysis was performed using SPSS software version 27.0, applying the Chi-square test.A p-value of less than 0.05 was considered statistically significant. Results:The mean age of the patients was 5.822.34years, and the majority of the participants (n=83, 76.15%) were female.The most common clinical symptoms were fever, anorexia, pain and irritability, as well as nausea and vomiting.DMSA scan findings revealed bilateral renal involvement in 57 (52.30%) patients.Leukocytosis was present in 31 (28.44%)cases, positive CRP in 69 (63.30%) cases, and elevated ESR in 73 (66.97%) cases.Elevated ESR or positive CRP showed no significant association with the severity of renal damage.However, severe renal involvement had a significant association with elevated leukocytosis and high-grade fever (>38C). Conclusion:The results of this study showed that clinical indicators such as high-grade fever may serve as early warning signs of renal damage in children with pyelonephritis.Nevertheless, DMSA scanning remains indispensable for the definitive detection of renal parenchymal injury.