title: Non-infectious causes of elevated procalcitonin and C-reactive protein serum levels in pediatric patients with hematologic and oncologic disorders.
abstract: BACKGROUND
  Procalcitonin (PCT) is considered a sensitive and specific diagnostic and prognostic marker of systemic bacterial infection, but its value is questionable in certain clinical conditions, particularly in hemato-oncological patients.
  
  
  METHODS
  We analyzed PCT and C-reactive protein (CRP) levels in 56 patients of a pediatric hematology-oncology unit during 110 consecutive non-infectious febrile episodes related to administration of T-cell antibodies (group A; n = 22), alemtuzumab (monoclonal CD52 antibody, CAMPATH-1H/group B; n = 8), interleukin-2 (IL-2/group C; n = 41), prophylactic donor granulocyte transfusions (group D; n = 9), or to acute graft-versus-host disease (aGvHD/group E; n = 10) and compared the results with 20 episodes of Gram-negative sepsis (group F).
  
  
  RESULTS
  In the majority of the non-infectious episodes PCT and CRP increased to serum levels statistically indistinguishable from Gram-negative sepsis. Median peak levels of PCT (normal < 0.5 ng/ml)/CRP (normal < 8 mg/l) for groups A-F were 4.34/59.0 (A), 10.14/93.5 (B), 1.11/175.0 (C), 1.43/164 (D), 0.96/34.0 (E), and 8.14 ng/ml /126.0 mg/l (F). Highest single levels were observed in groups A and F.
  
  
  CONCLUSIONS
  PCT and CRP are of limited value as diagnostic markers of sepsis during T-cell-directed immunomodulatory treatment, granulocyte support, or acute GvHD.
authors.affiliation: Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 30, Graz, Austria. hansjuergen.dornbusch@meduni-graz.at
authors.forename: Hans Jürgen
authors.initials: HJ
authors.lastname: Dornbusch
authors.forename: Volker
authors.initials: V
authors.lastname: Strenger
authors.forename: Petra
authors.initials: P
authors.lastname: Sovinz
authors.forename: Herwig
authors.initials: H
authors.lastname: Lackner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schwinger
authors.forename: Reinhold
authors.initials: R
authors.lastname: Kerbl
authors.forename: Christian
authors.initials: C
authors.lastname: Urban
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000097:blood; D006402:Hematologic Diseases / Q000097:blood / Q000175:diagnosis; D019337:Hematologic Neoplasms / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D007223:Infant; D007376:Interleukin-2 / Q000097:blood; D008297:Male; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; C000606589:CALCA protein, human; D007376:Interleukin-2; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide