https://doi.org/10.5812/pedinfect.10074

Is Urinary Beta-2 Microglobulin a Good Predictive Marker in Children With Pyelonephritis?

authors:

avatar Behnam Sobouti 1 , * , avatar Yaser Ghavami 2

Ali- Asghar Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
Burn Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
Archives of Pediatric Infectious Diseases: Vol.1, issue 2; 105-106
published online: July 15, 2013
article type: Letter
received: January 1, 2013
accepted: January 7, 2013

How To Cite Sobouti B, Ghavami Y. Is Urinary Beta-2 Microglobulin a Good Predictive Marker in Children With Pyelonephritis?. Arch Pediatr Infect Dis. 2013;1(2): 105-106. https://doi.org/10.5812/pedinfect.10074.

Dear Editor,

Regarding recently published article on urinary beta-2 microglobulin (ß2MG) as a prognostic marker in children with pyelonephritis, some issues should be considered (1). ß2MG is a small globular peptide with a molecular weight of 11800 Dalton which can be found on the surface of many cells. It consists of 100 amino acids with a disulfide-linked loop between amino acid 25 and 81; and its tertiary structure is homologous to the CH3- IgG domain. ß2MG passes freely through the glomerular membrane. Thereafter it is reabsorbed to an amount of maximum 99.9% by the proximal tubules (2). In aforementioned interesting article, the relation between urinary ß2M to Creatinine ratio and its effect on kidney damage may not be an incidental finding. Although it is possible to apply ß2M as a prognostic factor in patients with pyelonephritis, but exclusion criteria for patients should be extended more than mentioned. Other contributing factors in increased ß2M are infections (such as CMV and HIV), malignancies (i.e. multiple myeloma), exposure to heavy metals (Mercury, Cadmium), kidney transplant, amyloidosis and drugs (such as Lithium, Cyclosporine, Cisplatin, Aminoglycosides). These issues should be taken into account and are considered in the exclusion criteria (3-6).

References

  • 1.

    Sharifian M, Karimi A, Mohkam M, Dalirani R, Esfandiar N, Tabatabaei SR, et al. Urinary Beta 2-Microglobulin as a Prognostic marker in children with pyelonephritis. Arch Pediatr Infect Dis. 2012;1(1):18-22. https://doi.org/10.5812/pedinfect.4902.

  • 2.

    Lehmann CA. Saunders manual of clinical laboratory science. WB Saunders Company; 1998.

  • 3.

    Del Palacio M, Romero S, Casado JL. Proximal tubular renal dysfunction or damage in HIV-infected patients. AIDS Rev. 2012;14(3):179-87. [PubMed ID: 22833061].

  • 4.

    Heegaard NH. Beta(2)-microglobulin: from physiology to amyloidosis. Amyloid. 2009;16(3):151-73. [PubMed ID: 19657763]. https://doi.org/10.1080/13506120903151775.

  • 5.

    Liabeuf S, Lenglet A, Desjardins L, Neirynck N, Glorieux G, Lemke HD, et al. Plasma beta-2 microglobulin is associated with cardiovascular disease in uremic patients. Kidney Int. 2012;82(12):1297-303. [PubMed ID: 22895515]. https://doi.org/10.1038/ki.2012.301.

  • 6.

    Yang J, Qian J, Wezeman M, Wang S, Lin P, Wang M, et al. Targeting beta2-microglobulin for induction of tumor apoptosis in human hematological malignancies. Cancer Cell. 2006;10(4):295-307. [PubMed ID: 17045207]. https://doi.org/10.1016/j.ccr.2006.08.025.