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Karel Everaert, Joris Delanghe, Marc Vanderkelen, Kristof Cornelis, Stefaan De Wachter, Annick Viaene, Eddy De Ruyck, Bart Clarysse, Willem Oosterlinck
Urinary Plasma Protein Patterns in Acute Prostatitis
We evaluated the diagnostic utility of urinary ?1-microglobulin, ?2-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 ?2-macroglobulin/albumin ratio was significantly lower in prostatitis compared to the reference population, cystitis or acute pyelonephritis (p <0.0001). Low ?2-macroglobulin concentrations in prostatitis are due to inhibition (p = 0.0001) of the immune reaction between ?2-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 ?1-microglobulin/creatinine ratio diagnoses acute pyelonephritis (sensitivity 100% and specificity 87%) and the urinary ?2-macroglobulin/albumin ratio diagnoses acute prostatitis (sensitivity 100% and specificity of 90%). Stepwise multinomial logistic regression analysis reveals that urinary ?1-microglobulin, ?2-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, ?2-macroglobulin remains lower compared to patients without prostatitis.
Clinical Chemical Laboratory Medicine, Walter de Gruyter
Print ISSN: 1434-6621
Volume: 41, 01/2003
Pages: 79 - 84