calca-protein--human and Anemia--Sickle-Cell

The Pneumonia Severity Index (PSI) and CURB-65 predict outcomes in community acquired pneumonia but have limitations. The study evaluated if procalcitonin in community-acquired pneumonia provides prognostic information with the PSI and CURB-65 in sickle cell adult patients. Twenty sickle cell positive adult patients with a clinical and radiographic diagnosis of community acquired pneumonia were scored using PSI and CRUB-65, and measured procalcitonin levels. They were 12 female 60% and 8 males 40% with mean of age 46.0 +/- 10.26 and were stratified with PSI, CRUB65 and sampled for procalcitonin level for PSI class I (3) patients 15%, class II (10) patients 50%, class III (3) patients 15%, class IV (one) patient 5% and class V (3) patients 15% with mean of 2.55 +/- 1.276 were CRUB65 0 (2) patients 10% 1 (11) patients 55% two (3) patients 15%, three (4) patients 20% with mean of 1.45 +/- 0.94 proclacitonin >0.25 (8) patients 40% and >0.50 were (12) patients 60% with mean of 1.098 +/- 1.346.

Topics: Adult; Anemia, Sickle Cell; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Community-Acquired Infections; Female; Humans; Male; Middle Aged; Pneumonia, Bacterial; Protein Precursors

This study aimed at evaluating the value of C-reactive protein (CRP) and procalcitonin (PCT) levels in the differential diagnosis of fever in patients with sickle cell disease (SCD). The study included 86 children with SCD (group 1) and 49 controls (group 2). During the study, the patients had 114 acute episodes or routine visits to the units. They were classified as having vasoocclusive crisis with fever (group 1A), vasoocclusive crisis without fever (group 1B), and no crisis or fever (steady state, group 1C). Only patients with crises were admitted to the hospital. Patients admitted to the hospital with various clinical signs and symptoms each and every time were included in groups 1A, 1B, and 1C. Thus, a total of 114 clinical episodes were analyzed. The mean CRP levels in the 3 patient groups were significantly higher than that in the group 2, and among the patient groups, the mean CRP was significantly higher in group 1A than the other groups. The mean CRP level in group 1A and group 1B was significantly higher than that in group 1C. There were no significant differences among the 3 SCD groups in terms of the median serum PCT level; however, the median PCT level in group 1A, group 1B, and group 1C patients was significantly higher than that in group 2 patients. These data indicate that vasoocclusive disease with or without fever apparently does not significantly increase PCT levels in relation to the baseline status of children with SCD, which in turn are clearly more elevated than PCT levels of control children.

Topics: Adolescent; Anemia, Sickle Cell; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Child; Child, Preschool; Diagnosis, Differential; Female; Fever; Humans; Infant; Male; Protein Precursors

Fever is often present during painful vaso-occlusive crisis (VOC) in sickle-cell disease (SCD), but does not always indicate infection. The aim of our study was to test procalcitonin as a marker of invasive bacterial infection in VOC. Consecutive SCD adults hospitalized for VOC were included. Data were collected at admission and within 24 h after the onset of fever. We distinguished patients with clinically defined and microbiologically documented invasive bacterial infection from patients with no evidence of invasive bacterial infection and who fared well without antibiotics. One hundred and twelve patients were enrolled (61% females, median age 23 years, 88% homozygous SCD). All patients with procalcitonin (PCT) level ≥1 μg/L had an invasive bacterial infection, but two patients (33%) with an invasive bacterial infection had a PCT level <1 μg/L. High levels of PCT indicate invasive bacterial infection. However, a single low PCT level without follow-up measurement cannot rule out an invasive bacterial infection and should not withhold the prescription of antibiotics.

Topics: Adult; Anemia, Sickle Cell; Bacterial Infections; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Female; Humans; Male; Predictive Value of Tests; Prospective Studies; Protein Precursors

A pilot study was designed to determine if serum procalcitonin levels would assist in the diagnosis of severe bacterial infections in patients presenting to an emergency department (ED) with acute sickle cell pain crisis and evidence of acute inflammatory response.. Prospective single cohort study evaluating measured procalcitonin levels in patients with sickle cell pain crisis and evidence of acute inflammation. Acute inflammation was defined as fever (>38 degrees C) and/or elevation in the white blood cell count (>4000 above baseline) and tachycardia (heart rate >100). Procalcitonin was measured using a semi-quantitative monoclonal antibody test. Patients were followed clinically to determine if procalcitonin has predictive value in excluding severe bacterial infections.. Twenty four subjects were enrolled and completed the study. Sixteen had levels 0.5 ng/ml or less, two had levels 0.5 to 2 ng/ml, one had a level of 2 but less than 10 ng/ml, and four had levels 10 ng/ml or greater. All subjects with documented infections at presentation had procalcitonin levels > or =2.0 ng/ml. The sensitivity of the test in this study sample was 1, and the specificity was 0.95 (95% CI, 0.75-0.99).. A serum procalcitonin less than 2 ng/ml appears to have good negative predictive value in excluding serious bacterial infections in patients that present with acute sickle cell pain crisis and evidence of acute inflammatory response. Further study is needed to investigate if procalcitonin has positive predictive value in identifying patients with serious bacterial infections in this patient population.

Topics: Acute Disease; Anemia, Sickle Cell; Calcitonin; Calcitonin Gene-Related Peptide; Cohort Studies; Follow-Up Studies; Heart Rate; Humans; Infections; Inflammation; Leukocytes; Protein Precursors; Temperature