Urine macrophage migration inhibitory factor (MIF) in children with urinary tract infection: a possible predictor of acute pyelo nephritis but not scar

Macrophase inhibitory factor (MIF) is an important pro-inflammatory cytokine found in the sites of inflammation. The aim of this study was to assess MIF in urinary tract infection and compare its urinary excretion in pyelonephritis, cyctitis and control group to find a new way to differentiate them. In this prospective case-control study 33 pediatric patients with UTI and 40 healthy children were recruited. Urinary MIF concentration was determined using ELIZA DMSA renal scan was used as the gold standard to differentiate pyelonephritis from cystitis.Urine MIF/Cr ratio was significantly higher in pyelonephritis patients than the ones with acute cystitis and control group (P< 0.001). The optimal cut-off point of 4.90 pg/micromol creatinine for urine MIF/Cr ratio (which is determined by ROC analysis) could potentially separate acute pyelonephritis from acute cystitis. However, due to unability to evaluate renal scarring by this marker, DMSA renal scan would remain the more informative procedure.