Procalcitonin as a Biomarker for Bacterial Infections in Patients With Liver Cirrhosis in the Emergency Department

Li, Chih Huang; Yang, Ruey‐Bing; Pang, Jong‐Hwei S.; Chang, Shy Shin; Lin, Chih Chuan; Chen, Chien Hsiun; Chen, Hsien Yi; Chiu, Te Fa

doi:10.1111/j.1553-2712.2010.00991.x

Cited by 23 publications

(28 citation statements)

References 13 publications

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“…CRP was found to be 84.6% sensitive and 82.4% specific for detecting sepsis and the predicted cut-off value is ≥23.5 mg/L. This was similar to values derived by Chih-Huang Li et al 5 who observed a sensitivity of 80.0% and specificity of 80.3% for CRP in detecting sepsis with predicted cut-off of 24.7 mg/L. Among the two variables being tested, procalcitonin had the highest sensitivity and specificity (100% each) for detecting sepsis.…”

Section: Discussionsupporting

confidence: 87%

“…Procalcitonin was found to be 100% sensitive and specific for detecting sepsis and the predicted cut-off value is ≥0.744 µg/L. This was comparable to the observation made by Chih-Huang Li et al 5 who observed a sensitivity of 81.5% and specificity of 87.3% for PCT in detecting sepsis with predicted cut-off of 0.5 µg/L. CRP was found to be 84.6% sensitive and 82.4% specific for detecting sepsis and the predicted cut-off value is ≥23.5 mg/L.…”

Section: Discussionsupporting

confidence: 85%

“…PCT has the best diagnostic values among these biomarkers. 5 We conducted the present study to evaluate the role of procalcitonin and CRP in patients with cirrhosis of liver with and without sepsis and to find correlation of levels of procalcitonin and CRP with clinical and biochemical parameters of severity of cirrhosis as well as to find out its prognostic implications.…”

mentioning

confidence: 99%

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Evaluation of Procalcitonin and C-Reactive Protein in Patients of Cirrhosis of Liver With Sepsis- A Cross-Sectional Study

Kumar¹,

Verma²,

Singh³

et al. 2017

jebmh

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BACKGROUNDSepsis is commonly encountered in patients of cirrhosis of liver and is associated with worse outcome. Traditional culture methods commonly used to diagnose sepsis in such patients is positive only in 50-70% of cases and take longer time. Therefore, surrogate marker such as Procalcitonin (PCT) and C-Reactive Protein (CRP) may be useful to identify patients of early sepsis with increased sensitivity and in shorter time. The aim of the study is to-1. Evaluate the role of PCT and CRP in patients with cirrhosis of liver with and without sepsis. 2. Find correlation of levels of procalcitonin and CRP with clinical and biochemical parameters of severity of cirrhosis as well as to find out its prognostic implications.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 85%

mentioning

confidence: 99%

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Evaluation of Procalcitonin and C-Reactive Protein in Patients of Cirrhosis of Liver With Sepsis- A Cross-Sectional Study

Kumar¹,

Verma²,

Singh³

et al. 2017

jebmh

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“…Conversely, CRP levels will not increase in patients with liver failure or those on anti-IL-6 therapy, even if they have a severe infection 18,19 . Second, CRP is not useful in determining the causative pathogen.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Serum C-reactive Protein in the Management of Adult Community-acquired Pneumonia

Shoji

Teratani

Yoshida

et al. 2012

Showa Univ J Med Sci

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: C-Reactive protein CRP is widely used as a marker of infection, but there is insufficient evidence as to its usefulness in patients with community-acquired pneumonia CAP . In the present study, we investigated the clinical usefulness of CRP in a retrospective study of 242 patients aged ≥ 14 years who were hospitalized with CAP. Patients were classified into three groups according to the number of days between disease onset and the initial measurement of CRP as follows : Group 1, 0-1 day ; Group 2, 2-4 days ; Group 3, ≥ 5 days. Patients in Groups 2 and 3, who had more severe pneumonia, had higher CRP levels. Over time, CRP levels decreased in the responders in Groups 2 and 3 ; speci cally, in Group 2, median CRP levels on Days 0, 3, and 7 were 9.85, 5.33, and 0.81 mg/dL, respectively, compared with 9.99, 4.29, and 0.70 mg/dL, respectively, in Group 3. In patients not responding to initial treatment, median CRP levels increased from Day 0 to Day 3 4.32 vs. 11.70 mg/dL, respectively . In all non-responders, CRP levels on Day 3 were 50% of levels on Day 0. In conclusion, when measured approximately 48 h after disease onset, CRP is useful for evaluating the severity of pneumonia and predicting the response to treatment. A good clinical outcome is likely when CRP levels on Day 3 are ≤ 50% of those on admission.

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“…As the liver is believed to be a key source of PCT, there were initially concerns that hepatic impairment may result in downregulated serum PCT levels. Although, this was not proven to be the case [84] , and early reports were encouraging about the use of PCT in the diagnosis of SBP, its potential role remains currently unclear as several studies provided conflicting results [85][86][87][88][89][90][91][92][93] . A solution has been proposed with the use of an ultra-sensitive PCT assay [87] , and possible explanations for the discrepancies noted between studies include higher baseline levels in patient with alcoholic [94] or specific viral-related [95] causes of cirrhosis and the presence of other bacterial infections [96] .…”

Section: Calprotectin -Procalcitonin -Anti-neutrophil Cytoplasmic Antmentioning

confidence: 99%

Markers of bacterial translocation in end-stage liver disease

Koutsounas¹,

Kaltsa²,

Siakavellas³

et al. 2015

WJH

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Bacterial translocation (BT) refers to the passage of viable bacteria or bacterial products from the intestinal lumen, through the intestinal epithelium, into the systemic circulation and extraintestinal locations. The three principal mechanisms that are thought to be involved in BT include bacterial overgrowth, disruption of the gut mucosal barrier and an impaired host defence.BT is commonly observed in liver cirrhosis and has been shown to play an important role in the pathogenesis of the complications of end stage liver disease, including infections as well as hepatic encephalopathy and hepatorenal syndrome. Due to the importance of BT in the natural history of cirrhosis, there is intense interest for the discovery of biomarkers of BT. To date, several such candidates have been proposed, which include bacterial DNA, soluble CD14, lipopolysaccharides endotoxin, lipopolysaccharide-binding protein, calprotectin and procalcitonin. Studies on the association of these markers with BT have demonstrated not only promising data but, oftentimes, contradictory results. As a consequence, currently, there is no optimal marker that may be used in clinical practice as a surrogate for the presence of BT.

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Procalcitonin as a Biomarker for Bacterial Infections in Patients With Liver Cirrhosis in the Emergency Department

Cited by 23 publications

References 13 publications

Evaluation of Procalcitonin and C-Reactive Protein in Patients of Cirrhosis of Liver With Sepsis- A Cross-Sectional Study

Evaluation of Procalcitonin and C-Reactive Protein in Patients of Cirrhosis of Liver With Sepsis- A Cross-Sectional Study

Usefulness of Serum C-reactive Protein in the Management of Adult Community-acquired Pneumonia

Markers of bacterial translocation in end-stage liver disease

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