Urinary Plasma Protein Patterns in Acute Prostatitis
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Karel Everaert
Abstract
We evaluated the diagnostic utility of urinary α1-microglobulin, α2-macroglobulin and albumin in the diagnosis of acute prostatitis. We studied 133 men (43±17 years) with, and a reference population (n=36, 41±16 years) without, urinary tract infection. Prostatectomy samples were used to study the potential interference between prostatic proteins and protein analysis. Urinary α2-macroglobulin/albumin ratio was significantly lower in prostatitis compared to the reference population, cystitis or acute pyelonephritis (p <0.0001). Low α2-macroglobulin concentrations in prostatitis are due to inhibition (p = 0.0001) of the immune reaction between α2-macroglobulin in presence of polyclonal rabbit antibodies (used for immunonephelometry) by soluble prostatic proteins (± 60 kDa) which appear in urine in acute prostatitis. The urinary α1-microglobulin/creatinine ratio diagnoses acute pyelonephritis (sensitivity 100% and specificity 87%) and the urinary α2-macroglobulin/albumin ratio diagnoses acute prostatitis (sensitivity 100% and specificity of 90%). Stepwise multinomial logistic regression analysis reveals that urinary α1-microglobulin, α2-macroglobulin, albumin and creatinine provide optimal differentiation between acute pyelonephritis and acute prostatitis (pseudo R2=0.83; Loglikelihood −30.55, p <0.000001). In conclusion, the combination of hematuria and absence of urinary alpha-2-macroglobulin is diagnostic for acute prostatitis. Even without hematuria, α2-macroglobulin remains lower compared to patients without prostatitis.
Copyright © 2003 by Walter de Gruyter GmbH & Co. KG
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- Evidence-Based Laboratory Medicine: Addressing Bias, Generalisability and Applicability in Studies on Diagnostic Accuracy. The STARD Initiative
- Semen Polymorphonuclear Neutrophil Leukocyte Elastase as a Diagnostic and Prognostic Marker of Genital Tract Inflammation – A Review
- Total Oxyradical Scavenging Capacity toward Different Reactive Oxygen Species in Seminal Plasma and Sperm Cells
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- 3-Nitrotyrosine in Atherosclerotic Blood Vessels
- Molecular Diagnosis of Cystic Fibrosis: Comparison of Four Analytical Procedures
- Assessment of Intestinal Permeability: Enzymatic Determination of Urinary Mannitol, Raffinose, Sucrose and Lactose on Hitachi Analyzer
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- Towards Complete and Accurate Reporting of Studies of Diagnostic Accuracy: The STARD Initiative
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- Erratum: The 18th International Congress of Clinical Chemistry and Laboratory Medicine. Special Supplement Abstracts Issue 2002
- Meetings and Awards
