title: Utility of serum procalcitonin and C-reactive protein in severity assessment of community-acquired pneumonia in children.
abstract: OBJECTIVE
  Although the importance of serum Procalcitonin (PCT) levels at diagnosis is well established in adult Community-Acquired Pneumonia (CAP), its use remains controversial in pediatric CAP. The aim of our study is to investigate the role of PCT and C-Reactive Protein (CRP) in the assessment of pediatric CAP severity defined by the extent of consolidation on chest X-rays and the presence of pleural effusion. In this particular setting, no clinical severity score is available at present and chest X-ray, although important for diagnosis confirmation, is not recommended as routine test.
  
  
  METHODS
  The study involved 119 children admitted to the Department of Pediatric Infectious Disease for radiographically documented CAP aged 1 year to 14 years, without chronic diseases. Baseline PCT, CRP and routine laboratory tests were performed on admission.
  
  
  RESULTS
  The median PCT (μg/L) and CRP (mg/L) were 0.11 (0.05–0.58) and 21.3 (4.2–48.1), respectively. PCT showed a good correlation with CRP, neutrophils and WBC (r = 0.538, P < 0.001; r = 0.377, P < 0.001; r = 0.285, P0.002, respectively). CRP, but not PCT, was associated with lobar consolidation (P = 0.007) and pleural effusion (P = 0.002). Logistic regression analysis revealed that only CRP was a predictor of lobar consolidation (OR: 1.078; 95% CI: 1.017–1.143; P = 0.011) and pleural effusion (OR: 1.076; 95% CI: 1.005–1.153; P = 0.036).
  
  
  CONCLUSIONS
  Our findings revealed that PCT is correlated to the main inflammatory markers in children with CAP. CRP, unlike PCT, is able to predict the extent of chest X-ray infiltration and ultimately the severity of the disease confirming its usefulness in the management of pneumonia
authors.affiliation: Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche, Università degli studi di Palermo, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Agnello
authors.affiliation: Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche, Università degli studi di Palermo, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Bellia
authors.affiliation: UOC Malattie Infettive Pediatriche, Ospedale dei Bambini G. Di Cristina, ARNAS, Palermo, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Di Gangi
authors.affiliation: Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche, Università degli studi di Palermo, Italy.
authors.forename: Bruna
authors.initials: B
authors.lastname: Lo Sasso
authors.affiliation: Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche, Università degli studi di Palermo, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Calvaruso
authors.affiliation: Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche, Università degli studi di Palermo, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Bivona
authors.affiliation: Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche, Università degli studi di Palermo, Italy.
authors.forename: Concetta
authors.initials: C
authors.lastname: Scazzone
authors.affiliation: UOC Malattie Infettive Pediatriche, Ospedale dei Bambini G. Di Cristina, ARNAS, Palermo, Italy.
authors.forename: Piera
authors.initials: P
authors.lastname: Dones
authors.affiliation: Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche, Università degli studi di Palermo, Italy; UOC Medicina di Laboratorio-CoreLab, AOUP Policlinico P. Giaccone, Palermo, Italy. Electronic address: marcello.ciaccio@unipa.it.
authors.forename: Marcello
authors.initials: M
authors.lastname: Ciaccio
mesh_terms: D000293:Adolescent; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000097:blood* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D018410:Pneumonia, Bacterial / Q000097:blood* / Q000503:physiopathology; D011498:Protein Precursors / Q000097:blood*; D012720:Severity of Illness Index
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide
keywords: CRP; Lobar consolidation; Pediatric community-acquired pneumonia; Pleural effusion; Pneumococcal; Procalcitonin; Severity