calca-protein--human and Pleurisy

Procalcitonin (PCT) and C-reactive protein (CRP) measurements in pleural fluid and plasma have been proposed to facilitate differential diagnosis of pleural effusion (PE). The primary aim of this study was to evaluate the usefulness of these measurements when differentiating between benign (BPE) and malignant pleural effusion (MPE).. We prospectively studied 100 patients with the specific diagnosis of exudative PE. We analyzed the demographic data and the usual biochemical studies in PE. CRP and PCT were measured in pleural fluid and plasma before starting treatment.. The CRP levels in pleural fluid were higher in patients with BPE than in patients with MPE [33.1 mg/L (16.8 to 52.1) vs. 11.8 (5.1 to 22); p = 0.001], as were the plasma CRP levels [68.4 mg/L (26.1 to 119.1) vs. 30.2 (11.7 to 64.8); p = 0.007]. No differences in PCT levels were detected between the two patient populations. The AUC derived from the ROC curve analysis for plasma CRP and pleural fluid CRP were 0.667 (CI 95%: 0.551 - 0.782) and 0.752 (CI 95%: 0.653 - 0.852), respectively. Plasma CRP levels > or = 35.5 mg/L exhibited 71% sensitivity and 56% specificity in discriminating between BPE and MPE. Pleural fluid CRP levels > or = 16.7 mg/L had 75% sensitivity and 68% specificity in the diagnosis of BPE.. CRP levels in the pleural fluid and plasma were higher in patients with BPE, particulary infectious PE. However, the measurement of CRP and PCT is not a useful parameter for discriminating between BPE and MPE and does not provide useful information in clinical practice.

Topics: Adenocarcinoma; Adult; Aged; Biomarkers, Tumor; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Carcinoma; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Lymphoma, T-Cell; Male; Mesothelioma; Middle Aged; Neoplasm Proteins; Neoplasms; Pleural Effusion; Pleural Effusion, Malignant; Pleurisy; Prospective Studies; Protein Precursors; Sensitivity and Specificity

Diagnosis of tuberculous pleuritis is difficult because of its nonspecific clinical presentation and decreased efficiency of traditional diagnostic methods. We investigated the use of procalcitonin (PCT) concentration in tuberculous pleuritis diagnosis.. A prospective clinical study was performed with two different patient groups. A total of 28 patients were included: 18 with tuberculosis and 10 with nontuberculous pleurisy. Serum and pleural fluid PCT concentrations were evaluated before treatment.. Serum and pleural fluid PCT concentrations were statistically different between tuberculous and nontuberculous pleurisy groups (P = 0.012 and P = 0.004, respectively), even though they were not elevated in relation to the cut-off level of 0.5 ng/mL. A positive and significant correlation was detected between serum and pleural fluid PCT levels (r = 0.49, P = 0.008). Diagnostic specificity and sensitivity values for serum and pleural fluid PCT in discriminating tuberculous from nontuberculous pleurisy were 80% and 72.2%, and 90% and 66.7% at the 0.081 and 0.113 ng/mL cut-off values, respectively.. Relative to the current cut-off level of 0.5 ng/mL, PCT concentration is not a useful parameter for the diagnosis of tuberculous pleurisy. Because there were PCT levels in patients with tuberculous pleurisy that were below the current cut-off level but were significantly different from those of the nontuberculous group, the use of PCT should be further investigated.

Topics: Adolescent; Adult; Biomarkers; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Case-Control Studies; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Pleural Effusion; Pleurisy; Prospective Studies; Protein Precursors; Reference Values; Sensitivity and Specificity; Tuberculosis, Pleural

The aim of our study was to evaluate the prognostic value of serum procalcitonine (PCT) assay in adult respiratory infections. Forty-nine patients admitted with pleurisy, community-acquired pneumonia, tuberculosis, infection were included in this prospective study. PCT was assayed on admission and discharge. Biological and clinical parameters of gravity were also evaluated. Twenty patients had elevated PCT of more than 0.50 ng/ml. In 29 patients, PCT was undetectable. The serum PCT level was normal in the patients with tuberculosis, infection, pneumocytosis. PCT did not correlate with the biological and clinical markers of the disease severity but the evolution of PCT correlated with the evolution of C-reactive-protein (r = 0.58, p < 0.05). PCT seems to be an early marker of the evolution of respiratory infections, but it does not help to establish prognosis. Further studies are necessary to assess the potential value of PCT in more severe respiratory infections requiring assisted ventilation.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Analysis of Variance; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Diagnosis, Differential; Female; Glycoproteins; Humans; Linear Models; Male; Middle Aged; Pleurisy; Pneumonia; Pneumonia, Pneumocystis; Prognosis; Prospective Studies; Protein Precursors; Respiratory Tract Infections; Tuberculosis, Pulmonary