Early Identification of Biliary Pancreatitis With Procalcitonin

Brunkhorst, Frank M.; Eberhard, Oliver K.; Brunkhorst, Reinhard

doi:10.1111/j.1572-0241.1998.01191.x

Cited by 27 publications

(11 citation statements)

References 4 publications

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“…High PCT concentrations have been proposed to be indicative of biliary pancreatitis in the absence of other infectious complications (9). In accordance, we found PCT concentrations to be significantly higher in patients with biliary acute pancreatitis compared to patients with non-biliary etiology.…”

Section: Discussionsupporting

confidence: 88%

“…In addition, PCT has also been found to be an important diagnostic indicator to distinguish biliary from non-biliary pancreatitis (9). This prospective study was undertaken to assess the clinical utility of PCT as a predictive marker compared to the established biochemical markers and multiple factor scoring systems.…”

Section: Resultsmentioning

confidence: 99%

“…PCT has also been found to be an important diagnostic indicator to distinguish biliary from non-biliary pancreatitis (9). Early differentiation is crucial, as patients with severe acute pancreatitis due to gallstones benefit significantly from urgent endoscopic sphincterotomy (3,4).…”

Section: Introductionmentioning

confidence: 99%

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The Clinical Value of Procalcitonin in Early Assessment of Acute Pancreatitis

Modrau

Floyd

Thorlacius‐Ussing

2005

Am J Gastroenterology

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OBJECTIVES:Early assessment of the severity and the etiology is crucial in the management of acute pancreatitis. To determine the value of procalcitonin (PCT) as a prognostic marker and as an indicator of biliary etiology in the early phase of acute pancreatitis. METHODS:In a prospective study, 75 consecutive patients were included (severe pancreatitis in 12 patients, biliary etiology in 42 cases). The value of PCT as a prognostic marker was compared to C-reactive protein (CRP), hematocrit (HCT), acute physiology and chronic health evaluation (APACHE) II score, and Ranson score. The value of PCT as an indicator of biliary etiology was compared to alanine aminotransferase (ALT) and alkaline phosphatase (AP). The area under the receiver operating characteristic curve (AUC) was applied as a measure of the overall accuracy of the single markers and multiple scoring systems. RESULTS:The most accurate prediction of severe disease was provided by the APACHE II score on the day of admission ( CONCLUSIONS: PCT is of limited additional value for early assessment of severity and etiology in acute pancreatitis. CRP is found to be a reliable prognostic marker with a delay of 48 h, while ALT is validated as the best indicator of biliary etiology.(Am J Gastroenterol 2005;100:1593-1597)

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Section: Discussionsupporting

confidence: 88%

Section: Resultsmentioning

confidence: 99%

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The Clinical Value of Procalcitonin in Early Assessment of Acute Pancreatitis

Modrau

Floyd

Thorlacius‐Ussing

2005

Am J Gastroenterology

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“…Recently, PCT was found to be elevated in patients with severe bacterial or fungal infections and sepsis (2,3,(15)(16)(17). The diagnostic and prognostic value of elevated levels of PCT was first described by Nylen et al in 1992 (18) in severely burned patients.…”

Section: Introductionmentioning

confidence: 96%

Comparison of Procalcitonin, sCD14 and Interleukin-6 Values in Septic Patients

Herrmann

Ecker²,

Quast³

et al. 2000

CCLM

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The aim of the study was to investigate whether procalcitonin, soluble CD14 and interleukin-6 show advantages in predicting the outcome and specificity for bacterial infection in patients with sepsis in comparison to common C-reactive protein measurement. Laboratory parameters were measured in plasma of patients during 14 days following the diagnosis of sepsis. Patients fulfilling the ACCP/SCCM criteria for sepsis were admitted to an intensive care unit (n=35). Procalcitonin was measured with an immunoluminometric assay, and soluble CD14 and interleukin-6 were analysed by ELISA. C-reactive protein was determined nephelometrically. Measurements were performed on days 0, 1, 2, 3, 4, 7 and 14. Separating the patients into survivors (n=22) and non-survivors (n=13), it was demonstrated that non-survivors mostly exhibited, after the day of admission, increasing procalcitonin concentrations which peaked around days three and four. In contrast, the procalcitonin concentrations of survivors fell continuously to the value of 2.1 ng/ml which was reported to be important for patients prognosis. The difference between procalcitonin median values of survivors (n=22) and non-survivors (n=13) attained the level of statistical significance on day 7 and on day 14 (p=0.05). When comparing the median values of Creactive protein, soluble CD14 and interleukin-6 between survivors and non-survivors, no significant differences were detectable. In this study, plasma concentrations of soluble CD14 and interleukin-6 showed no predictive value for patients' outcome as compared with established laboratory parameters such as C-reactive protein or leukocyte count. Monitoring of procalcitonin seemed to detect severe episodes of sepsis and may improve the laboratory monitoring of septic patients.

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“…So konnten bei Pankreatitis infizierte von sterilen Nekrosen mit hoher Spezifität mit Hilfe von PCT differenziert werden [18,19]. Ebenso wurden bei einer toxisch bedingten Pankreatitis deutlich niedrigere PCT-Werte nachgewiesen als bei biliärer Ätiologie [20]. Bei einem ARDS isolierter toxischer oder nichtbakterieller Ätiologie wurden im Vergleich zur infektiösen Ätiologie niedrigere PCT-Werte beschrieben [21][22][23].…”

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