Procalcitonin and Pancreatic Stone Protein Function as Biomarkers in Early Diagnosis of Pediatric Acute Osteomyelitis

Abstract

BackgroundHigh plasma levels of procalcitonin (PCT) are typically seen in children with severe bacterial infection, particularly in cases of septic shock or bacteremia. Similarly, pancreatic stone protein (PSP) is associated with inflammation, infection, and other disease-related stimuli. However, the prognostic value of PSP in critically ill pediatric patients is unknown. This study investigated the early diagnostic value of PCT and PSP in pediatric acute osteomyelitis.Material/MethodsA total of 187 patients with suspected acute osteomyelitis and 80 healthy control children were enrolled. The serum expression of PTC and PSP was measured. Pearson correlation analysis was conducted to correlate PTC with PSP. ROC analysis was used to test the value of PTC and PSP in early diagnosis of pediatric acute osteomyelitis.ResultsAcute osteomyelitis was diagnosed in 49.2% of the patients (n=92) based on the layered bone puncture. The serum levels of PTC and PSP in pediatric acute osteomyelitis were higher than in the non-acute osteomyelitis group (P<0.01). Serum PTC concentrations showed a significantly positive correlation with PSP levels (P<0.001). ROC analysis showed that the AUC values of PTC and PSP were 0.767 (95% CI, 0.700–0.826), and 0.796 (95% CI, 0.731–0.855), respectively. The AUC value of PTC & PSP was 0.903 (95% CI: 0.851–0.941), which was markedly increased compared with PTC or PSP (P<0.01).ConclusionsSerum levels of PCT and PSP are promising biomarkers for early diagnosis of pediatric acute osteomyelitis.

Measurement of Pancreatic Stone Protein in the Identification and Management of Sepsis

“…Data on the diagnostic performance of PSP for sepsis are also available for children and neonates. In children, the combination of PSP, PCT and CRP was superior to each of the individual markers for the risk stratification of pediatric sepsis [42], and the combination of PSP and PCT had significantly higher diagnostic accuracy for osteomyelitis than that of PSP or PCT alone [43]. In neonates, a population particularly at risk of sepsis and associated with high morbidity and mortality, a high negative predictive value of PSP, alone or in combination with PCT was found for early onset neonatal sepsis, which supports the concept of using PSP to rule out sepsis and thereby safely reduce antibiotic treatment in this specific population [39,40].…”

“…A recent technology based on nanofluidics (abioSCOPE, Abionic SA, Epalinges, Switzerland) allows quantifying proteins at the picomolar range from a drop of whole blood in a few minutes and without preanalytic work. Nanofluidic channels strongly influence the diffusional behavior of biomolecules and increase molecular interactions [43]. Due to the submicron structuration, the binding surface for the capture biomolecule is strongly increased, which enhances the sensitivity of the sensor and the biomolecular interaction leading to reduced assay times (Figure 1).…”

Future Biomarkers for Infection and Inflammation in Febrile Children

“…Irrespective of age, pancreatic stone protein (PSP) which is secreted by the pancreas in response to stress during systemic infection, has been studied in both infants and adults to predict sepsis (54) and was developed into a point-of-care test by Abionic. However, proper validation is needed because PSP levels are elevated in various other diseases as well (55)(56)(57).…”

Lactate Dehydrogenase (LDH) dan prokalsitonin merupakan parameter pembeda yang lebih spesifik dan sensitif dibandingkan dengan Laju Endap Darah (LED), C-Reactive Protein (CRP), dan Alkaline Phosphatase (ALP) antara osteosarkoma dan osteomielitis di RSUP S

“…Studi deskriptif menunjukkan bahwa median usia dari kelompok pasien osteosarkoma adalah 17 (6) tahun, sedangkan untuk osteomielitis, median usia adalah 42,5 (33) tahun sehingga terdapat perbedaan bermakna dari median umur kedua kelompok tersebut (p <0,001) (Tabel 1). Sedangkan untuk jenis kelamin, sebagian besar responden berjenis kelamin laki-laki baik pada kelompok osteosarkoma (67,50%) dan kelompok osteomielitis (60,00%) pada adalah laki-laki, dan, 13 sampel pada kelompok osteosarkoma dan 16 sampel pada kelompok osteomielitis adalah perempuan dengan perbedaan proporsi yang tidak bermakna antar kedua kelompok (p=0,485).…”

“…Pada penelitian oleh Cui C et al, yang meneliti nilai diagnosis awal PCT pada anak-anak dengan osteomielitis, didapatkan rerata kadar PCT dapat mencapai 5.2±4.27 ng/mL. 33 Sedangkan penelitian oleh van Asten SA et al, yang membahas mengenai parameter laboratorium untuk menilai kesuksesan terapi pada kaki diabetes dengan osteomielitis, didapatkan kadar PCT sebelum terapi sebesar 0,26 ng/mL, namun tidak didapatkan perbedaan signifikan dengan nilai PCT setelah 3 dan 6 minggu menjalani pengobatan. 20 Analisis diskriminan yang dilakukan menghasilkan nilai struktur matriks terbesar untuk variabel PCT dan LDH, yaitu sebesar 0,637 dan 0,542 secara berurutan.…”