Non-infectious causes of elevated procalcitonin and C-reactive protein serum levels in pediatric patients with hematologic and oncologic disorders

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
H J DornbuschChristian Urban

Abstract

Procalcitonin (PCT) is considered a sensitive and specific diagnostic and prognostic marker of systemic bacterial infection, but its value is questionable in certain clinical conditions, particularly in hemato-oncological patients. We analyzed PCT and C-reactive protein (CRP) levels in 56 patients of a pediatric hematology-oncology unit during 110 consecutive non-infectious febrile episodes related to administration of T-cell antibodies (group A; n = 22), alemtuzumab (monoclonal CD52 antibody, CAMPATH-1H/group B; n = 8), interleukin-2 (IL-2/group C; n = 41), prophylactic donor granulocyte transfusions (group D; n = 9), or to acute graft-versus-host disease (aGvHD/group E; n = 10) and compared the results with 20 episodes of Gram-negative sepsis (group F). In the majority of the non-infectious episodes PCT and CRP increased to serum levels statistically indistinguishable from Gram-negative sepsis. Median peak levels of PCT (normal < 0.5 ng/ml)/CRP (normal < 8 mg/l) for groups A-F were 4.34/59.0 (A), 10.14/93.5 (B), 1.11/175.0 (C), 1.43/164 (D), 0.96/34.0 (E), and 8.14 ng/ml /126.0 mg/l (F). Highest single levels were observed in groups A and F. PCT and CRP are of limited value as diagnostic markers of sepsis during T-cell-direct...Continue Reading

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Citations

Jan 21, 2011·Scandinavian Journal of Clinical and Laboratory Investigation·Jana UhrovaTomas Zima
Dec 7, 2010·International Journal of Antimicrobial Agents·Konrad Reinhart, Christiane S Hartog
Mar 13, 2009·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Shailendra Kapoor
Feb 8, 2013·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Y-X LyuM-Y Zhu
May 24, 2016·Neurology. Neuroimmunology and Neuroinflammation·Katja ThomasTjalf Ziemssen
Feb 6, 2017·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Ricardo Garcia Branco, Pedro Celiny Ramos Garcia
Dec 27, 2017·JAAPA : Official Journal of the American Academy of Physician Assistants·Elyse J Watkins, James Guerrini
Dec 21, 2017·Terapevticheskiĭ arkhiv·N L Ryabkova, N N Vezikova
Apr 28, 2020·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Susan E SmithJulie Kalabalik-Hoganson
Apr 30, 2009·Anaesthesia and Intensive Care·K M Ho, J Lipman
Jun 16, 2021·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Sunyoung AhnSang-Guk Lee

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