Procalcitonin serum levels in tertian malaria.
BACKGROUND
Procalcitonin (PCT) is closely correlated with parasite burden and clinical outcome in falciparum malaria. The role of PCT in tertian malaria has not previously been investigated.


METHODS
PCT serum levels in 37 patients with tertian malaria were analysed. Clinical and laboratory parameters were assessed and statistically correlated both to the initial PCT levels and during the course of the disease.


RESULTS
PCT levels rose for one day after commencing treatment and declined thereafter. However, there was no significant correlation with parasite burden, clinical parameters, laboratory values, or the presence of semi-immunity. Before treatment, the majority of patients showed normal or slightly elevated PCT levels (< 2.5 ng/ml), but PCT was markedly elevated (4.8-47 ng/ml) in one third of the population. The two groups did not differ by any other of the assessed parameters. Thus, while the post-treatment course of PCT resembles falciparum malaria, the lack of correlation between disease severity and even high PCT levels in a large proportion of patients is intriguing.


CONCLUSIONS
There is a fundamental difference in the relationship of PCT with tertian malaria not seen in other infectious diseases in which elevated PCT levels have been observed. This suggests distinct pathophysiological pathways in malaria.
Manegold
Christoph
C
Bernhard Nocht Institute for Tropical Medicine Bernhard-Nocht-Str, 74 20359 Hamburg Germany. manegold@bni.uni-hamburg.de
Schmiedel
Stefan
S
Chiwakata
Collins B
CB
Dietrich
Manfred
M
D000818:Animals; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D006801:Humans; D008288:Malaria / Q000097:blood; D016780:Malaria, Vivax / Q000097:blood*; D041122:Plasmodium ovale / Q000302:isolation & purification*; D010966:Plasmodium vivax / Q000302:isolation & purification*; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide