The Usefulness of Spot Urine Protein/Creatinine Ratio in Evaluating Proteinuria in Children and the Correlation between 24-hour Urinary Protein Amount and Spot Urine Protein/Creatinine Ratio

PURPOSE: Recently, different results about factors affecting accurate quantitation of 24-hr urinary protein(24UP) amount using spot urine protein/creatinine ratio(PCR) have been reported. The current study was designed to evaluate correlation between 24UP amounts and PCR in children, and the effect of 24UP amounts, age, sex, and glomerular filtration rate(GFR) on this correlation. METHODS: Among 94 patients who visited the department of pediatrics in Busan Paik Hospital from March 2002 to August 2002, 68 patients whose urinary creatinine excretion was > or = 15 mg/kg/day were included in this study. All the patients were divided into I, II/A, B group(I : 24UP or = 500 mg/day, A : or = 10 years of age). Pearson correlation analysis was performed between 24UP and PCR to evaluate the relationship. We defined fractional difference between 24UP and PCR, and then performed multiple regression analysis with 24UP amount, age, GFR and fractional difference. RESULTS: There was a strong positive linear correlation between 24UP and PCR(R=0.936, P or = 500 mg. The factors affecting accurate quantitation of proteinuria using spot urine PCR was age, not 24UP amount, GFR or sex. CONCLUSION: Spot urine PCR is a useful test but has limitations in predicting 24UP amount. Therefore, it should be used only as screening method. Age-adjusted PCR cutoff values may be necessary to predict 24UP amount in children with proteinuria.

Pericardial Effusion:Report of Three Unusual Cases

Pericardial effusions can be developed by any form of pericarditis; infective pericarditis such as viral or bacterial infection and non-infective, inflammatory pericarditis related with generalized disease such as end-stage renal disease or connective tissue disease and irradiation, postpericardiectomy syndrome, drugs and non-inflammatory pericarditis by malignancy, hypothyroidism, trauma on chest. In children, pericardial effusions are usually related with viral infection, generalized disease or cardiac surgery. We experienced three unusual cases of pericadial effusion by Mycoplasma pneumonia infection, Rickettsia tsutsugamushi infection and post-thoracotomy effusive constrictive pericarditis.

A Case of Myocarditis by Measles Virus

Myocarditis is inflammation, necrosis and myocytolysis of myocardium by many infectious, connective tissue, granulomatous, toxic, or idiopathic process. Viruses are probably the most important cause of myocarditis. But the exact cause remains unknown in the majority of patients with presumed myocarditis. We describe a case of myocarditis by measles virus in a 11-year-old girl with a brief review of related literatures.