Serum Procalcitonin in Cirrhotic Patients with Septic Shock: Relationship with Adrenal Insufficiency and Clinical Outcomes

Al‐Dorzi, Hasan M.; Rishu, Asgar; Tamim, Hani; Aljumah, Abdulrahman; Al-Tamimi, Waleed; Baharoon, Salim; Dabbagh, Tarek Al; Arabi, Yaseen M.

doi:10.7754/clin.lab.2013.130636

Cited by 3 publications

(3 citation statements)

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“…However, it was not easy to distinguish the role of this patient's amoebic liver abscess from his underlying disease. As it has been reported in cases of bacterial sepsis (de Azevedo et al, 2012;Prkno et al, 2013;Wacker et al, 2013), the mean PCT level in our study (4.03 μg/L) was well above the threshold of 0.50 μg/L that is sometimes used in practice (Al-Dorzi HM et al, 2014;Syvanen J et al, 2014) for distinguishing between bacterial infection and viral disease (Piacentini et al, 2011) or other causes of unspecific inflammation (Anand et al, 2015;Tsalik et al, 2012). However, it is worth noting that individual values appeared heterogeneous and were globally lower than the rates observed during bacterial sepsis (de Azevedo et al, 2012;Prkno et al, 2013;Wacker et al, 2013).…”

Section: Discussionsupporting

confidence: 71%

“…The role of PCT has also been widely discussed in invasive fungal infections (Dou et al, 2013;Marková et al, 2013;Cortegiani et al, 2014). Overall, it is considered that low levels (b0.50 μg/L) (Al-Dorzi et al, 2014) usually rule out all of the above-mentioned infections and point towards virus (Piacentini et al, 2011) or nonspecific inflammatory diseases (Tsalik et al, 2012;Anand et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Is procalcitonin increased in cases of invasive amoebiasis? A retrospective, observational study

Recipon

Piver

Caille

et al. 2015

Diagnostic Microbiology and Infectious Disease

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Procalcitonin (PCT) levels are commonly used for diagnostic guidance in routine bacterial infections. By contrast, little data are currently available regarding PCT in parasitic diseases, and its role in cases of invasive amoebiasis has not yet been described. For this purpose, 35 adult patients with a proven diagnosis of invasive or digestive amoebiasis were included in a 4-year study period. Serum PCT was retrospectively assessed. Results were analysed with regard to the usual inflammatory biomarkers, like C-reactive protein (CRP). PCT was significantly higher in patients with proven invasive amoebiasis than in digestive amoebiasis (mean value: 4.03 μg/L versus 0.07 μg/L, respectively; P < 0.001), but the SD was greater than with CRP, and the effect was less than that demonstrated in bacterial infections. By contrast, PCT was not shown to be elevated during digestive amoebiasis.

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Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Is procalcitonin increased in cases of invasive amoebiasis? A retrospective, observational study

Recipon

Piver

Caille

et al. 2015

Diagnostic Microbiology and Infectious Disease

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“…Studies in this clinical setting only exist regarding CRP[19,20,63-75] and PCT[76-80] and their findings are not without controversies. In Table 2 we summarized available data on clinical significance of CRP and PCT in short or long-term mortality of patients with cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Presepsin teardown - pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis

Papp¹,

Tornai²,

Vitális³

et al. 2016

WJG

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AIMTo evaluate the diagnostic and prognostic value of presepsin in cirrhosis-associated bacterial infections.METHODSTwo hundred and sixteen patients with cirrhosis were enrolled. At admission, the presence of bacterial infections and level of plasma presepsin, serum C-reactive protein (CRP) and procalcitonin (PCT) were evaluated. Patients were followed for three months to assess the possible association between presepsin level and short-term mortality.RESULTSPresent 34.7 of patients had bacterial infection. Presepsin levels were significantly higher in patients with infection than without (median, 1002 pg/mL vs 477 pg/mL, P < 0.001), increasing with the severity of infection [organ failure (OF): Yes vs No, 2358 pg/mL vs 710 pg/mL, P < 0.001]. Diagnostic accuracy of presepsin for severe infections was similar to PCT and superior to CRP (AUC-ROC: 0.85, 0.85 and 0.66, respectively, P = NS for presepsin vs PCT and P < 0.01 for presepsin vs CRP). At the optimal cut-off value of presepsin > 1206 pg/mL sensitivity, specificity, positive predictive values and negative predictive values were as follows: 87.5%, 74.5%, 61.8% and 92.7%. The accuracy of presepsin, however, decreased in advanced stage of the disease or in the presence of renal failure, most probably because of the significantly elevated presepsin levels in non-infected patients. 28-d mortality rate was higher among patients with > 1277 pg/mL compared to those with ≤ 1277 pg/mL (46.9% vs 11.6%, P < 0.001). In a binary logistic regression analysis, however, only PCT (OR = 1.81, 95%CI: 1.09-3.01, P = 0.022) but neither presepsin nor CRP were independent risk factor for 28-d mortality after adjusting with MELD score and leukocyte count.CONCLUSIONPresepsin is a valuable new biomarker for defining severe infections in cirrhosis, proving same efficacy as PCT. However, it is not a useful marker of short-term mortality.

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Biomarkers for the Early Diagnosis of Bacterial Infection and the Surveillance of Hepatocellular Carcinoma in Cirrhosis

et al. 2015

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The early detection of bacterial infections and hepatocellular carcinoma (HCC) could ameliorate the prognosis of cirrhosis. C-reactive protein and procalcitonin are under investigation in the setting of cirrhosis as markers of sepsis. In the attempt to discriminate bacterial infection from systemic inflammation, the role of novel biomarkers such as lypopolysaccharide binding-protein, mid-regional fragment of pro-adrenomedullin and delta neutrophil index are currently in development. Concerning HCC, many studies attempted to evaluate biomarkers in the hope of ameliorating the accuracy of the surveillance based on ultrasound. The use of α-fetoprotein (AFP) has been extensively investigated, as well as other biomarkers expressed in the serum of HCC patients like lens culinaris agglutinin-reactive fraction of AFP, des-γ-carboxy prothrombin, glypican-3, α-l-fucosidase and their combined use.

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Serum Procalcitonin in Cirrhotic Patients with Septic Shock: Relationship with Adrenal Insufficiency and Clinical Outcomes

Cited by 3 publications

References 0 publications

Is procalcitonin increased in cases of invasive amoebiasis? A retrospective, observational study

Is procalcitonin increased in cases of invasive amoebiasis? A retrospective, observational study

Presepsin teardown - pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis

Biomarkers for the Early Diagnosis of Bacterial Infection and the Surveillance of Hepatocellular Carcinoma in Cirrhosis

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