A1 Refereed original research article in a scientific journal
Discrepancies between plasma procalcitonin and C-reactive protein levels are common in acute illness
Authors: Ivaska L, Elenius V, Mononen I, Ruuskanen O, Peltola V
Publisher: WILEY-BLACKWELL
Publication year: 2016
Journal: Acta Paediatrica
Journal name in source: ACTA PAEDIATRICA
Journal acronym: ACTA PAEDIATR
Volume: 105
Issue: 5
First page : 508
Last page: 513
Number of pages: 6
ISSN: 0803-5253
DOI: https://doi.org/10.1111/apa.13293
Abstract
Aim: Procalcitonin (PCT) and C-reactive protein (CRP) are biomarkers of bacterial infection
with distinct clinical qualities. This study aimed to determine the occurrence and
significance of discrepancies in plasma PCT and CRP levels in hospitalised children.
Methods: This was a single centre, retrospective analysis of simultaneous PCT and CRP
measurements. Clinical characteristics, microbiological findings and diagnoses were
compared between cases in which only PCT or CRP levels were elevated.
Results: We studied 635 pairs of PCT and CRP measurements and found discrepancies in
29% of these. In the group with increased PCT and low CRP, there were more children with
hypoxia or haemodynamic stress (14 versus 0, p < 0.001) and more bacteraemic patients
(eight versus zero, p = 0.001) than in the group with low PCT and increased CRP. The
latter group was associated with focal bacterial infections (three versus 18, p = 0.009),
inflammatory conditions (one versus 12, p = 0.016) and postoperative setting (one versus
19, p = 0.001). Diabetic ketoacidosis was associated with a marked elevation of PCT.
Conclusion: Discrepancies in plasma PCT and CRP levels occurred in 29% of acutely ill
children. Both biomarkers can increase in the absence of bacterial infection, but PCT may
offer an advantage over CRP in the diagnosis of bacteraemia.
Aim: Procalcitonin (PCT) and C-reactive protein (CRP) are biomarkers of bacterial infection
with distinct clinical qualities. This study aimed to determine the occurrence and
significance of discrepancies in plasma PCT and CRP levels in hospitalised children.
Methods: This was a single centre, retrospective analysis of simultaneous PCT and CRP
measurements. Clinical characteristics, microbiological findings and diagnoses were
compared between cases in which only PCT or CRP levels were elevated.
Results: We studied 635 pairs of PCT and CRP measurements and found discrepancies in
29% of these. In the group with increased PCT and low CRP, there were more children with
hypoxia or haemodynamic stress (14 versus 0, p < 0.001) and more bacteraemic patients
(eight versus zero, p = 0.001) than in the group with low PCT and increased CRP. The
latter group was associated with focal bacterial infections (three versus 18, p = 0.009),
inflammatory conditions (one versus 12, p = 0.016) and postoperative setting (one versus
19, p = 0.001). Diabetic ketoacidosis was associated with a marked elevation of PCT.
Conclusion: Discrepancies in plasma PCT and CRP levels occurred in 29% of acutely ill
children. Both biomarkers can increase in the absence of bacterial infection, but PCT may
offer an advantage over CRP in the diagnosis of bacteraemia.
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