Hematology and Oncology Book

Coagulopathy

Complete Blood Count

Lymphatic Disorders

Acute Phase Reactant

SPEP

Anemia

Cancer

Platelet Disorders

Hemolytic Disorders

Bone Marrow Disorders

Peripheral

Pharmacology Chapter related topics

//fpnotebook.com/

Procalcitonin

Aka: Procalcitonin, proCT
  1. Indication
    1. Marker of Bacterial Infection and Sepsis
  2. Physiology
    1. Peptide produced in the Thyroid, lung and intestin
    2. Calcitonin precursor (involved in Calcium Homeostasis)
    3. Remains at low levels when well
    4. Increases in inflammatory states, rising within 4 hours of infection onset and peaking at 12 to 48 hours
      1. Postulated to increase markedly in Bacterial Infection
      2. Postulated to allow for monitoring treatment response due to Procalcitonin short half-life
  3. Interpretation
    1. Procalcitonin level <0.05: Normal
    2. Procalcitonin level <0.25: Bacterial Sepsis unlikely
    3. Vijayan (2017) J Intensive Care 5:51 +PMID: 28794881 [PubMed]
  4. Efficacy: Adults
    1. Mediocre efficacy in Sepsis diagnosis
      1. Test Sensitivity: 77%
      2. Test Specificity: 79%
      3. Wacker (2013) Lancet Infect Dis 13(5): 426-35 +PMID: 23375419 [PubMed]
    2. Low efficacy in Pneumonia diagnosis
      1. Maisel (2013) Ear J Heart Fail 14(3): 278-86 +PMID: 22302662 [PubMed]
    3. Worse outcomes in ICU when Procalcitonin was used to direct antibiotic management
      1. Bouadma (2010) Lancet 375(9713): 463-74 +PMID: 20097417 [PubMed]
  5. Efficacy: Children
    1. See Serious Bacterial Infection in Children (Occult Bacteremia)
    2. Variable efficacy, although initial studies had very high accuracy in septic children
      1. Test Sensitivity: 26-55% for Bacterial Infection
      2. Test Specificity: 75 to 82% for Bacterial Infection
    3. Interpretation
      1. PCT <0.5 ng/ml has a Negative Predictive Value for serious Bacterial Infection of 90%
      2. PCT >0.6 (and WBC >19k, blasts >1.8k, Neutrophils >13k) suggests serious Bacterial Infection
    4. References
      1. Gendrel (1996) J Pediatr 128:570-3 [PubMed]
      2. Olaciregui (2009) Arch Dis Child 94(7): 501-5 +PMID:19158133 [PubMed]
      3. Mahajan (2014) Acad Emerg Med 21(2): 171-9 +PMID:24673673 [PubMed]
  6. References
    1. Orman, Herbert, Spiegel in Herbert (2016) EM:Rap 16(10):12-3
    2. Dolatabadi (2015) Niger Med J 56(1):17-22 +PMID:25657488 [PubMed]

procalcitonin (C0072027)

Concepts Amino Acid, Peptide, or Protein (T116) , Biologically Active Substance (T123)
MSH C029100
SnomedCT 418752001
LNC LP31682-5, MTHU015794
English calcitonin precursor polyprotein, Calcitonin, pro-, pro calcitonin, procalcitonin, Procalcitonin, Calcitonin precursor polyprotein, Procalcitonin (substance)
Spanish procalcitonina (sustancia), procalcitonina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


You are currently viewing the original 'fpnotebook.com\legacy' version of this website. Internet Explorer 8.0 and older will automatically be redirected to this legacy version.

If you are using a modern web browser, you may instead navigate to the newer desktop version of fpnotebook. Another, mobile version is also available which should function on both newer and older web browsers.

Please Contact Me as you run across problems with any of these versions on the website.

Navigation Tree