Serial procalcitonin responses in infection of children with secondary immunodeficiency.
OBJECTIVE
Procalcitonin has proven to be a sensitive inflammatory marker in non-neutropenic patients. The aim of this study was to determine and compare Procalcitonin with other inflammatory markers in the serum of immunosuppressed children with haematological malignancies; and to assess the predictive value of these mediators in distinguishing between bacterial and non-bacterial infection.


RESULTS
The study included 37 children with acute lymphoblastic leukaemia undergoing intensive chemotherapy. They were divided into 3 groups, A, B and C. Group A consisted of 29 neutropenic children with 94 febrile episodes, group B of 20 neutropenic children with 56 afebrile episodes and group C of 13 non-neutropenic children with 58 afebrile episodes. Serial serum levels of PCT, C-Reactive Protein, Neopterin, Interleukin-6 and NO2/NO3 were all determined on a day-to-day basis for 7 consecutive days. In serum the concentrations of CRP was determined by nephelometry, of PCT by immunoluminescence and of Neopterin, IL-6 and NO2/NO3 by ELISA method.


CONCLUSIONS
According to our results the Procalcitonin concentration increased rapidly in patients with microbial infection; the response was detectable within 24 hs of the onset of fever due to microbial infections. Procalcitonin is a specific and sensitive marker of microbial infection in patients with neutropenic fever. The markers, C-Reactive Protein, Interleukin-6 and NO2/NO3 may not help to identify infections and distinguish the etiology of infection in neutropenic febrile children with acute lymphoblastic leukaemia.
Hatzistilianou
M
M
2nd Department of Paediatrics, Aristotle University of Thessaloniki, Greece. nontas@topo.auth.gr
Rekleity
A
A
Athanassiadou
F
F
DeLutiis
M A
MA
Conti
P
P
Catriu
D
D
D000293:Adolescent; D001424:Bacterial Infections / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D004358:Drug Therapy / Q000379:methods; D064420:Drug-Related Side Effects and Adverse Reactions; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007108:Immune Tolerance / Q000187:drug effects* / Q000276:immunology; D007223:Infant; D015850:Interleukin-6 / Q000097:blood; D019798:Neopterin / Q000097:blood; D009391:Nephelometry and Turbidimetry; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy*; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*
C000606589:CALCA protein, human; D015850:Interleukin-6; D011498:Protein Precursors; D019798:Neopterin; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide