title: Potential use of procalcitonin as a diagnostic criterion in febrile neutropenia: experience from a multicentre study.
abstract: In order to assess the diagnostic value of procalcitonin, 158 patients with febrile neutropenia from centres across Europe were studied. Patients with fever were diagnosed on the basis of either: (1) clinical, radiological and microbiological criteria; or (2) the procalcitonin value. In the latter case, concentrations of 0.5-1.0 ng/mL were considered diagnostic of localised infection, concentrations of 1.0-5.0 ng/mL of bacteraemia, and concentrations of > 5.0 ng/mL of severe sepsis. Procalcitonin and C-reactive protein were estimated daily in serum by immunochemiluminescence and nephelometry, respectively. Overall, the sensitivity (specificity) of procalcitonin for bacteraemia was 44.2% (64.3%) at concentrations of 1.0-5.0 ng/mL, and 83.3% (100%) for severe sepsis at concentrations of > 5.0 ng/mL. It was concluded that procalcitonin is a marker strongly suggestive of severe sepsis at concentrations of > 5.0 ng/mL. Estimated concentrations of < 0.5 ng/mL indicate that infection is unlikely, but it was observed that bacteraemia associated with coagulase-negative staphylococci may fail to elevate serum procalcitonin levels.
authors.affiliation: 4th Department of Internal Medicine, Athens Medical School, Athens, Greece. giamarel@internet.gr
authors.forename: H
authors.initials: H
authors.lastname: Giamarellou
authors.forename: E J
authors.initials: EJ
authors.lastname: Giamarellos-Bourboulis
authors.forename: P
authors.initials: P
authors.lastname: Repoussis
authors.forename: L
authors.initials: L
authors.lastname: Galani
authors.forename: N
authors.initials: N
authors.lastname: Anagnostopoulos
authors.forename: P
authors.initials: P
authors.lastname: Grecka
authors.forename: D
authors.initials: D
authors.lastname: Lubos
authors.forename: M
authors.initials: M
authors.lastname: Aoun
authors.forename: K
authors.initials: K
authors.lastname: Athanassiou
authors.forename: E
authors.initials: E
authors.lastname: Bouza
authors.forename: E
authors.initials: E
authors.lastname: Devigili
authors.forename: V
authors.initials: V
authors.lastname: Krçmery
authors.forename: F
authors.initials: F
authors.lastname: Menichetti
authors.forename: E
authors.initials: E
authors.lastname: Panaretou
authors.forename: E
authors.initials: E
authors.lastname: Papageorgiou
authors.forename: D
authors.initials: D
authors.lastname: Plachouras
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000175:diagnosis*; D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis*; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006095:Gram-Positive Cocci / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000175:diagnosis*; D011498:Protein Precursors / Q000097:blood*; D012680:Sensitivity and Specificity
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide