calca-protein--human and Syndrome

In febrile children and adults, it is frequently difficult, based on the sole clinical examination, to differentiate a bacterial illness from systemic inflammatory syndromes or severe viral infections. However, the positive and rapid diagnosis of a severe bacterial infection or a sepsis is essential to initiate lifesaving therapies. Among the numerous infectious biomarkers that have recently been investigated, procalcitonin has the best diagnostic yield. Plasma levels below 0.5 microg/l usually rule out a severe bacterial disease, whereas values above 2 microg/l are strongly indicative of a bacterial sepsis. The usefulness and the limitations of the measurement of procalcitonin as a diagnostic and a prognostic tool during severe bacterial infections are discussed in this paper.

Topics: Adult; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Child; Diagnosis, Differential; Fever; Glycoproteins; Humans; Inflammation; Protein Precursors; Sepsis; Syndrome; Virus Diseases

Topics: Bacterial Infections; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Child; Child, Preschool; Female; Fever; Humans; Lymphadenitis; Male; Protein Precursors; Sepsis; Stomatitis, Aphthous; Syndrome

To study the correlation between serum procalcitonin (PCT) level and severity of infant muggy syndrome (IMS) and the predictive value of PCT in the development of multiple organ dysfunction syndrome (MODS) in children with IMS.. Fifty children with IMS were classified into two groups according to the presence of MODS: MODS (n=29) and non-MODS (n=21). According to a 30-day follow-up result, they were classified into survival (n=36) and deceased groups (n=14). Vital signs, routine biological measurements (arterial blood gas, blood routine, CRP, liver and kidney functions, myocardial enzyme and so on) and the disease severity evaluated by the Pediatric Critical Illness Score (PCIS) within 24 hours of admission were recorded. Serum levels were measured using the semi-quantitative PCT-Q test within 24 hours of admission.. Forty-seven children (94%) had elevated serum PCT levels (≥ 0.5 ng/mL) at admission. There were lower PCIS scores, higher rates of MODS and higher levels of serum PCT in deceased patients than survivors (P<0.05). There was a significant negative correlation between serum PCT levels and PCIS scores (r=-0.84, P<0.05). Serum PCT levels in the MODS group were significantly higher than in the non-MODS group (P<0.01). Receiver operating characteristic curve showed that, if the cut-off point of serum PCT level was 10.6 ng/mL, the sensitivity and specificity of PCT were 79.3% and 90.5% respectively, in predicting MODS, with the area under the curve of 0.924 ( P<0.01).. Serum PCT level at admission is correlated with the severity of IMS and it may be an early predictive marker of MODS.

Topics: Calcitonin; Calcitonin Gene-Related Peptide; Female; Humans; Infant; Infant, Newborn; Male; Multiple Organ Failure; Protein Precursors; Syndrome

To assess the levels of procalcitonin (PCT) and C-reactive protein (CRP) in children diagnosed with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) during their febrile attacks.. 23 patients with diagnosis of PFAPA included into the study prospectively during a three years period. In these patients, CRP and PCT values were recorded during 78 febrile episodes. Furthermore, 20 patients with diagnosis of pneumonia were chosen as a control group and their CRP and PCT values were measured. Normal reference values for CRP and PCT were 0-10 mg/L and 0-0.5 ng/mL, respectively.. Mean CRP and PCT values of patients with PFAPA were 94.8±71.6 mg/L and 0.29±0.14 ng/mL, respectively. In control group, mean CRP value was 153.2±26 mg/L and PCT was 1.59±0.53 ng/mL. CRP and PCT were high in control group. CRP was detected high and PCT was normal in PFAPA. Compared to control group, in PFAPA group, CRP values were not significantly (p>0.05) and PCT values were significantly lower (p<0.001).. During febrile episodes in the patients with diagnosis of PFAPA, CRP values were substantially elevated, whereas PCT values were within normal levels. Concomitant assessment of CRP and PCT in addition to clinical diagnostic criteria may be of help in making diagnosis and distinguishing febrile attacks from infections. However, studies in larger groups are required.

Topics: C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Child; Child, Preschool; Female; Hereditary Autoinflammatory Diseases; Humans; Lymphadenitis; Male; Pharyngitis; Prospective Studies; Protein Precursors; Stomatitis, Aphthous; Syndrome

Guidelines recommend that two blood cultures be performed in patients with febrile urinary tract infection (UTI), to detect bacteremia and help diagnose urosepsis. The usefulness and cost-effectiveness of this practice have been criticized. This study aimed to evaluate clinical characteristics and the biomarker procalcitonin (PCT) as an aid in predicting bacteremia.. A prospective observational multicenter cohort study included consecutive adults with febrile UTI in 35 primary care units and 8 emergency departments of 7 regional hospitals. Clinical and microbiological data were collected and PCT and time to positivity (TTP) of blood culture were measured.. Of 581 evaluable patients, 136 (23%) had bacteremia. The median age was 66 years (interquartile range 46 to 78 years) and 219 (38%) were male. We evaluated three different models: a clinical model including seven bed-side characteristics, the clinical model plus PCT, and a PCT only model. The diagnostic abilities of these models as reflected by area under the curve of the receiver operating characteristic were 0.71 (95% confidence interval (CI): 0.66 to 0.76), 0.79 (95% CI: 0.75 to 0.83) and 0.73 (95% CI: 0.68 to 0.77) respectively. Calculating corresponding sensitivity and specificity for the presence of bacteremia after each step of adding a significant predictor in the model yielded that the PCT > 0.25 μg/l only model had the best diagnostic performance (sensitivity 0.95; 95% CI: 0.89 to 0.98, specificity 0.50; 95% CI: 0.46 to 0.55). Using PCT as a single decision tool, this would result in 40% fewer blood cultures being taken, while still identifying 94 to 99% of patients with bacteremia.The TTP of E. coli positive blood cultures was linearly correlated with the PCT log value; the higher the PCT the shorter the TTP (R(2) = 0.278, P = 0.007).. PCT accurately predicts the presence of bacteremia and bacterial load in patients with febrile UTI. This may be a helpful biomarker to limit use of blood culture resources.

Topics: Adult; Aged; Aged, 80 and over; Bacteremia; Bacterial Load; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Cohort Studies; Female; Fever; Humans; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Protein Precursors; Sepsis; Syndrome; Urinary Tract Infections

We present a patient who developed carbamazepine (CBZ)-induced Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome associated with high serum procalcitonin (PCT). The presentation (high fever, hepatosplenomegaly, leukocytosis), high PCT and CRP initially suggested sepsis, and he was treated with antibiotics, while CBZ was continued. The rash and hepatitis worsened. After withdrawal of CBZ, corticosteroid therapy was administered and the patient recovered with normalization of PCT. This case demonstrates that PCT may be increased in patients with DRESS. This is the first report of CBZ-induced DRESS associated with high PCT, and the second case of increased PCT in DRESS.

Topics: Adolescent; Calcitonin; Calcitonin Gene-Related Peptide; Carbamazepine; Drug Hypersensitivity; Humans; Male; Protein Precursors; Syndrome

The aim of this study is to determine the relation of high-sensitive serum C-reactive protein (hsCRP) and procalcitonin with presence and severity of coronary artery disease and early prognosis in patients with acute coronary syndrome (ACS).. Procalcitonin and hsCRP levels were measured at admission and after 48 hours in 50 patients (41 men, 9 women) with ACS. The patients were assigned to three groups according to their clinical diagnosis: unstable angina pectoris (UAP) (Braunwald III-B), non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI). Incidences of adverse cardiac events were recorded in a 3-month follow-up. Coronary angiography was performed to evaluate presence and severity of coronary artery disease. In the groups of STEMI, NSTEMI and UAP, procalcitonin (P = 0.01 3, P = 0.045 and P = 0.000 1, respectively) and hsCRP (P = 0.000 1, P = 0.01 and P = 0.00 1, respectively) levels were significantly increased. No significant correlation was found between these markers and the presence and severity of coronary artery disease. There was no correlation between procalcitonin and hsCRP levels at admission and after 48 hours and primary end points after 3 months except in the group of UAP with revascularization procedure. In the group of UAP, hsCRP levels at 48 hours were found higher in the patients with a revascularization procedure (P = 0.04).. In conclusion, levels of hsCRP and procalcitonin are increased in patients with ACS but failed to correlate with severity of coronary disease and early prognosis.

Topics: Acute Disease; Adult; Aged; Analysis of Variance; Angina, Unstable; Angioplasty, Balloon, Coronary; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Coronary Angiography; Coronary Artery Bypass; Coronary Artery Disease; Creatine Kinase, MB Form; Female; Follow-Up Studies; Humans; Inflammation Mediators; Male; Middle Aged; Myocardial Infarction; Prognosis; Protein Precursors; Research Design; Severity of Illness Index; Syndrome; Treatment Outcome; Troponin I; Turkey

Topics: Calcitonin; Calcitonin Gene-Related Peptide; Drug Eruptions; Eosinophilia; Humans; Protein Precursors; Severity of Illness Index; Stevens-Johnson Syndrome; Syndrome

Topics: Anti-Bacterial Agents; Calcitonin; Calcitonin Gene-Related Peptide; Community-Acquired Infections; Fever; Humans; Protein Precursors; Syndrome