Procalcitonin and other acute phase reactants in patients with chronic obstructive pulmonary disease exacerbation

Abstract

The aim of this study was to investigate the correlation between procalcitonin and other acute phase reactants, and also analyze their relationship with clinical situation in chronic obstructive pulmonary disease (COPD) acute exacerbations. Materials and methods: The study was made with 122 acute COPD exacerbated patients, who were admitted to emergency service. Patients with below 0.25 ng/ml PCT value included Group 1, and the patients with PCT values ≥ 0.25 ng/ml Group 2. Serum procalcitonin levels, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) values and white blood cell (WBC) counts were measured. Also, patients hospitalization time and mortality rates were recorded and compared with PCT. Results: Patients were divided in 3 groups according to their clinical diagnosis; Pneumonia (n=27), Mycoplasma-Chlamydia pneumonia (n=11) and the patients with only COPD exacerbation(n=84). Mean PCT values according to the groups were 9.47 ± 8.1 ng/ml, 0.41 ± 0.2 ng/ ml, and 0.21 ± 0.05 ng/ml respectively. The relationship between PCT with CRP and white blood cell has been found between significiant (p=0.001, p=0.005 respectively), whereas the relationship between PCT and ESR was nonsignificant (p=0.55). Procalcitonin and CRP had a positive correlation with the hospitalization time (p=0.034, p=0.022 respectively). The mean ± standard error of PCT for the patients who died was 28.3 ± 27.5 ng/ml, and the difference between patients who died or were discharged was statistically significant (p= 0.012). Conclusion: PCT can be a useful indicator for morbidity and prognosis in COPD patients.

The diagnostic value of proteoglycan 4 in the differentiation of stable and exacerbation periods in chronic obstructive pulmonary disease: a preliminary study

“…Chang et al stated that there was no relationship between the WBC count and exacerbation period [8]. Civelek et al reported that the increase in the WBC count during the exacerbation period was not statistically significant [11]. In our study, there was no significant difference in the WBC count between patients in the exacerbation period and those in the stable period.…”

“…Literature review revealed that several laboratory parameters (CRP, PCT, nitric oxide, galectin-3, L-arginine, changes in leukocyte count or formula, etc.) have been investigated in order to distinguish the exacerbation and stable periods of COPD [8][9][10][11][12][13][14]. However, there are only few studies investigating the relationship between PRG4 and COPD, and the results show that PRG4 levels increase in patients with COPD [15,16].…”

“…Although it is recommended that PCT is studied to clarify the etiology of the disease and the treatment choice during the exacerbation period of COPD, the gradual bacterial colonization that occurs in COPD renders it difficult to use PCT in the diagnosis [25][26][27][28]. Flattet et al reported that PCT levels were not significantly elevated during the exacerbation period of COPD, whereas Civelek et al found that PCT levels were particularly high in exacerbations caused by infections [11,26]. Chang et al, on the other hand, did not find a relationship between PCT level and exacerbation period [8].…”