title: Procalcitonin levels in patients with Lyme borreliosis.
abstract: BACKGROUND
  Serum and cerebrospinal fluid (CSF) procalcitonin levels were assessed and compared for different groups of patients with Lyme borreliosis.
  
  
  METHODS
  50 adult patients with Lyme borreliosis, referred to our department from March to June 2001, were included in this prospective study. Patients were divided into three groups. The first group consisted of 20 consecutive patients with typical solitary erythema migrans, representing early localised Lyme borreliosis, the second group comprised 20 patients with early disseminated Lyme borreliosis (10 with multiple erythema migrans and 10 with neuroborreliosis), and 10 patients with acrodermatitis chronica athrophicans represented the group with chronic Lyme borreliosis. Blood specimens were taken from all patients included in the study, but CSF samples were restricted to those with disseminated and chronic Lyme borreliosis. The serum and CSF procalcitonin levels were determined utilizing the LUMI PCT (an immunoluminometric assay using two antigen-specific monoclonal antibodies).
  
  
  RESULTS
  Serum and CSF procalcitonin levels were in normal range in the large majority of patients. The levels of serum procalcitonin did not differ in the three groups of patients with Lyme borreliosis (p = 0.5006). The corresponding values for patients with solitary erythema migrans (early localised Lyme borreliosis), early disseminated Lyme borreliosis, and chronic Lyme borreliosis were 0.26 (0.11-0.43), 0.22 (0.10-0.67), and 0.28 (0.13-0.66) microgram/ml, respectively. Moreover, procalcitonin levels in CSF were also low and comparable for patients with multiple erythema migrans (median 0.38, range 0.24-0.54 microgram/ml), neuroborreliosis (median 0.16, range 0.10-0.47 microgram/ml), and acrodermatitis chronica athrophicans (median 0.30, range 0.15-0.45 microgram/ml). The differences were not statistically significant (p = 0.7579).
  
  
  CONCLUSIONS
  In the large majority of patients with Lyme borreliosis procalcitonin values are within normal range. Serum and CSF procalcitonin levels are of no value for differentiation between early localised, early disseminated and chronic Lyme borreliosis.
authors.affiliation: Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia. stanka.lotric-furlan@mf.uni-lj.si
authors.forename: Stanka
authors.initials: S
authors.lastname: Lotric-Furlan
authors.forename: Vera
authors.initials: V
authors.lastname: Maraspin-Carman
authors.forename: Joze
authors.initials: J
authors.lastname: Cimperman
authors.forename: Katarina
authors.initials: K
authors.lastname: Ogrinc
authors.forename: Tanja
authors.initials: T
authors.lastname: Stopar
authors.forename: Franc
authors.initials: F
authors.lastname: Strle
mesh_terms: D000169:Acrodermatitis / Q000175:diagnosis / Q000276:immunology; D000328:Adult; D025065:Borrelia burgdorferi / Q000276:immunology; D002116:Calcitonin / Q000378:metabolism*; D015740:Calcitonin Gene-Related Peptide; D003937:Diagnosis, Differential; D015787:Erythema Chronicum Migrans / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007075:Immunoglobulin M / Q000378:metabolism; D008193:Lyme Disease / Q000175:diagnosis* / Q000276:immunology; D020852:Lyme Neuroborreliosis / Q000175:diagnosis / Q000276:immunology; D008297:Male; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000378:metabolism*
chemical_list: C000606589:CALCA protein, human; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide