Procalcitonin assay in systemic inflammation, infection, and sepsis: Clinical utility and limitations

Critical Care Medicine

Volumn 36, Issue 3, 2008, Pages 941-952

  Becker, Kenneth L ^a,b   Snider, Richard ^a   Nylen, Eric S ^a,b  

^a VETERANS AFFAIRS MEDICAL CENTER   (United States)

^b GEORGE WASHINGTON UNIVERSITY   (United States)

Author keywords

Infection; Inflammation; Procalcitonin; Sepsis

Indexed keywords

C REACTIVE PROTEIN; PROCALCITONIN; CALCITONIN; PROTEIN PRECURSOR;

BACTERIAL INFECTION; DISEASE MARKER; DISEASE SEVERITY; HORMONE DETERMINATION; HUMAN; HYPERPROCALCITONEMIA; INFECTION; INFLAMMATION; MEDLINE; METABOLIC DISORDER; MYCOSIS; NEUROENDOCRINE DISEASE; OUTCOME ASSESSMENT; PARASITOSIS; PATHOPHYSIOLOGY; PATIENT MONITORING; PRIORITY JOURNAL; PROGNOSIS; PROTEIN BLOOD LEVEL; REFERENCE VALUE; REPRODUCIBILITY; REVIEW; RISK FACTOR; SENSITIVITY AND SPECIFICITY; SEPSIS; VIRUS INFECTION; BLOOD;

CALCITONIN; HUMANS; INFECTION; INFLAMMATION; PROTEIN PRECURSORS; SENSITIVITY AND SPECIFICITY; SEPSIS;

EID: 44449113393     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0B013E318165BABB     Document Type: Review

References (164)

1. Aalto H, Takala A, Kautiainen H, et al: Laboratory markers of systemic inflammation as predictors of bloodstream infection in acutely ill patients admitted to hospital in medical emergency. Eur J Clin Microbiol Infect Dis 2004;23:699-704
2. Liaudat S, Dayer E, Praz G, et al: Usefulness of procalcitonin serum level for the diagnosis of bacteremia. Eur J Clin Microbiol Infect Dis 2001;20:524-527
3. Suprin E, Camus C, Gacouin A, et al: Procalcitonin: A valuable indicator of infection in a medical ICU? Intensive Care Med 2000;26:1232-1238
4. Lopez Sastre JB, Perez Solis D, Roques Serradilla V, et al: Procalcitonin is not sufficiently reliable to be the sole marker of neonatal sepsis of nosocomial origin. BMC Pediatr 2006;6:16
5. Giamarellos-Bourboulis EJ, Mega A, Greeka A, et al: Procalcitonin a marker to clearly differentiate systemic inflammatory response syndrome and sepsis in the critically ill patient? Intensive Care Med 2002;28:1351-1356
6. Blommendahl J, Janas M, Laine S, et al: Comparison of procalcitonin with CRP and differential white blood cell count for diagnosis of culture-proven neonatal sepsis. Scand J Infect Dis 2002;34:620-622
7. Ugarte H, Silva E, Mercan D, et al: Procalcitonin used as a marker of infection in the intensive care unit. Crit Care Med 1999;27:498-504
8. Becker KL, Nylen ES, White JC, et al: Procalcitonin and the calcitonin gene family of peptides in inflammation, infection, and sepsis: A journey from calcitonin back to its precursors. J Clin Endocrinol Metab 2004;89:1512-1525
9. Tashjian AH Jr, Howland BG, Melvin K E W, et al: Immunoassay of human calcitonin. N Engl J Med 1970;283:890-895
10. Silva OL, Becker KL, Primack A, et al: Ectopic production of calcitonin. Lancet 1973;2:317
11. Silva OL, Broder LE, Doppman JL, et al: Calcitonin as a marker for bronchogenic cancer: A prospective study. Cancer 1979;44:680-684
12. Becker KL, Snider RH, Silva OL, et al: Calcitonin heterogeneity in lung cancer and medullary thyroid cancer. Acta Endocrinol (Copenh) 1978;89:89-99
13. Bihan H, Becker KL, Snider RH, et al: Calcitonin precursor levels in human medullary thyroid carcinoma. Thyroid 2003;13:819-822
14. Saad MF, Ordonez NG, Rashid RK, et al: Medullary carcinoma of the thyroid: A study of the clinical features and prognostic factors in 161 patients. Medicine (Baltimore) 1984;63:319-342
15. Nylen E, Muller B, Becker KM, et al: The future diagnostic role of procalcitonin levels: The need for improved sensitivity. Clin Infect Dis 2003;36:823-824
16. Müller B, Christ-Crain M, Nylen ES, et al: Limits to the use of the procalcitonin level as a diagnostic marker. Clin Infect Dis 2004;39:1867-1868
17. Nylen ES, Jeng J, Jordan MH, et al: Late pulmonary sequela following burns: Persistence of hyperprocalcitonemia using a 1-57 amino acid N-terminal flanking peptide assay. Respir Med 1995;89:41-46
18. Snider RH Jr, Nylen ES, Becker KL: Procalcitonin and its component peptides in systemic inflammation: Immunochemical characterization. J Investig Med 1997;45:552-560
19. Ammori BJ, Becker KL, Kite P, et al: Calcitonin precursors: Early markers of gut barrier dysfunction in patients with acute pancreatitis. Pancreas 2003;27:239-243
20. Ammori BJ, Becker KL, Kite P, et al: Calcitonin precursors in the prediction of severity of acute pancreatitis on the day of admission. Br J Surg 2003;90:197-204
21. Whang KT, Steinwald PM, White JC, et al: Serum calcitonin precursors in sepsis and systemic inflammation. J Clin Endocrinol Metab 1998;83:3296-3301
22. Uzzan B, Cohen R, Nicolas P, et al: Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: A systematic review and meta-analysis. Crit Care Med 2006;34:1996-2003
23. Stucker F, Herrmann F, Graf JD, et al: Procalcitonin and infection in elderly patients. J Am Geriatr Soc 2005;53:1392-1395
24. Meisner M, Tschaikowsky K, Hutzler A, et al: Postoperative plasma concentrations of procalcitonin after different types of surgery. Intensive Care Med 1998;24:680-684
25. Beloborodova NV, Popov DA: Diagnostic value of some markers of infection in cardiosurgical patients in the early postoperative period. Anesteziol Reanimatol 2005;3:45-49
26. Bossink AW, Groeneveld A B J, Thijs LG: Prediction of microbial infection and mortality in medical patients with fever: Plasma procalcitonin, neutrophilic elastase-alpha1-antitrypsin, and lactoferrin compared with clinical variables. Clin Infect Dis 1999;29:398-407
27. Boussekey N, Leroy O, Georges H, et al: Diagnostic and prognostic values of admission procalcitonin levels in communityacquired pneumonia in an intensive care unit. Infection 2005;33:257-263
28. Thayvil S, Shenoy M, Hamaluba M, et al: Is procalcitonin useful in early diagnosis of serious bacterial infections in children? Acta Pediatr 2005;94:155-158
29. Nylen ES, O'Neill W, Jordan MH, et al: Serum procalcitonin as an index of inhalation injury in burns. Horm Metab Res 1992;24:439-442
30. Nylen ES, Snider RH Jr, Thompson KA, et al: Pneumonitis-associated hyperprocalcitoninemia. Am J Med Sci 1996;312:12-18
31. O'Neill WJ, Jordan MH, Lewis MS, et al: Serum calcitonin may be a marker for inhalation injury in burns. J Burn Care Rehabil 1992;24:439-443
32. Carsin H, Assicot M, Feger F, et al: Evolution and significance of circulating procalcitonin levels compared with Il-6, TNFα, and endotoxin levels early after thermal injury. Burns 1997;23:218-224
33. Bertsch T, Richter A, Hofheinz H, et al: Procalcitonin: A new marker for acute phase reaction in acute pancreatitis. Langenbecks Arch Chir 1997;362:367-372
34. Rau B, Schilling MK, Beger HG: Laboratory markers of severe acute pancreatitis. Dig Dis 2004;22:247-257
35. Nylen ES, Alarifi AA, Becker KL, et al: Effect of classical heatstroke on serum procalcitonin. Crit Care Med 1997;25:1362-1365
36. Merle C, Lepouse C, De Garine A: Surgery for mesenteric infarction: Prognostic factors associated with early death within 72 hours. J Cardiothorac Vasc Anesth 2004;18:734-741
37. Wanner GA, Keel M, Steckholzer U, et al: Relationship between procalcitonin plasma levels and severity of injury, sepsis, organ failure, and mortality in injured patients. Crit Care Med 2000;28:950-957
38. Sauerland S, Hensler T, Bouillon B, et al: Plasma levels of procalcitonin and neopterin in multiple trauma patients with or without brain injury. J Neurotrauma 2003;20:953-960
39. Hammer S, Fuchs AT, Rinker C, et al: Interleukin-6 and procalcitonin in serum of children undergoing cardiac surgery with cardiopulmonary bypass. Acta Cardiol 2004;59:624-629
40. Chesney RW, McCarron DM, Haddad JG, et al: Pathogenic mechanisms of the hypocalcemia of the staphylococcal toxic-shock syndrome. J Lab Clin Med 1983;101:576-585
41. Assicot M, Gendrel D, Carsin H, et al: High serum procalcitonin concentrations in patients with sepsis and infection. Lancet 1993;341:515-518
42. Müller B, White JC, Nylen ES, et al: Ubiquitous expression of the calcitonin-1 gene in multiple tissues in response to sepsis. J Clin Endocrinol Metab 2001;86:396-404
43. Domenech VS, Nylen ES, White JC, et al: Calcitonin gene-related peptide expression in sepsis: Postulation of microbial infection-specific response elements within the calcitonin I gene promoter. J Invest Med 2001;49:514-521
44. Nylen ES, Whang KT, Snider RH Jr, et al: Mortality is increased by procalcitonin and decreased by an antiserum reactive to procalcitonin in experimental sepsis [see editorial]. Crit Care Med 1998;26:1001-1006
45. Wagner KE, Martinez JM, Vath SD, et al: Early immunoneutralization of calcitonin precursors markedly attenuates the adverse physiologic response to sepsis in pigs. Crit Care Med 2002;30:2313-2321
46. Martinez JM, Wagner KE, Snider RH, et al: Late immunoneutralization of procalcitonin arrests the progression of lethal porcine sepsis. Surg Infect (Larchmt) 2001;2:193-201
47. Becker KL, Nylen ES, Snider RH, et al: Immunoneutralization of procalcitonin as therapy of sepsis. J Endotoxin Res 2003;9:367-374
48. Ryan CM, Yarmush ML, Burke JF, et al: Increased gut permeability early after burns correlates with the extent of burn injury. Crit Care Med 1992;20:1508-1512
49. Magnotti LJ, Deitch EA: Burns, bacterial translocation, gut barrier function, and failure. Burn Care Rehabil 2005;26:383-391
50. Dandona P, Nix D, Wilson MF, et al: Procalcitonin increase after endotoxin injection in normal subjects. J Clin Endocrinol Metab 1994;79:1605-1608
51. Preas HL Jr, Nylen ES, Snider RH, et al: Effects of anti-inflammatory agents on serum levels of calcitonin precursors. J Infect Dis 2001;184:373-376
52. Meisner M, Adina H, Schmidt J: Correlation of procalcitonin and C-reactive protein to inflammation, complications, and outcome during the intensive care unit course of multiple-trauma patients. Crit Care 2006;10: R1
53. Oconnor E, Venkatesh B, Mashongonyika C, et al: Serum procalcitonin and C-reactive protein as markers of sepsis and outcome in patients with neurotrauma and subarachnoid haemorrhage. Anaesth Intensive Care 2004;32:465-470
54. Hensler T, Sauerland S, Lefering R, et al: The clinical value of procalcitonin and neopterin in predicting sepsis and organ failure after major trauma. Shock 2003;20:420-426
55. Castelli GP, Pognani C, Meisner M, et al: Procalcitonin and C-reactive protein during systemic inflammatory response syndrome, sepsis and organ dysfunction. Crit Care 2004; R234-R242
56. Sponholz C, Sakr Y, Reinhart K, et al: Diagnostic value and prognostic implications of serum procalcitonin after cardiac surgery: A systematic review of the literature. Crit Care 2006;10: R145
57. Macrina F, Tritapepe L, Pompei F, et al: Procalcitonin is useful whereas C-reactive protein is not, to predict complications following coronary artery bypass surgery. Perfusion 2005;20:169-175
58. Celebi S, Koner O, Menda F, et al: Procalcitonin kinetics in pediatric patients with systemic inflammatory response after open heart surgery. Intensive Care Med 2006;32:881-887
59. Dorge H, Schondube FA, Dorge P, et al: Procalcitonin is a valuable prognostic marker in cardiac surgery but not specific for infection. Thorac Cardiovasc Surg 2003;51:322-326
60. Von Heimburg D, Stieghorst W, Khorram-Sefat R, et al: Procalcitonin: A sepsis parameter in severe burn injuries. Burns 1998;24:745-750
61. Nyamande K, Lalloo UG: Serum procalcitonin distinguishes CAP due to bacteria, Mycobacterium tuberculosis and PJP. Int J Tuberc Lung Dis 2006;10:510-515
62. Jereb M, Kotar T: Usefulness of procalcitonin to differentiate typical from atypical community-acquired pneumonia. Wien Klin Wochenschr 2006;118:170-174
63. Prat C, Dominguez J, Andreo F, et al: Procalcitonin and neopterin correlation with aetiology and severity of pneumonia. J Infect 2006;52:169-177
64. Gervaix A, Galetto-Lacour A, Gueron T, et al: Usefulness of procalcitonin and C-reactive protein rapid tests for the management of children with urinary tract infection. Pediatr Infect Dis 2001;20:507-516
65. Pecile P, Miorin E, Romanello C, et al: Procalcitonin: A marker of severity of acute pyelonephritis among children. Pediatrics 2004;114: e249-e254
66. Martinot M, Sordet C, Soubrier M, et al: Diagnostic value of serum and synovial procalcitonin in acute arthritis: A prospective study of 42 patients. Clin Exp Rheumatol 2005;23:303-310
67. Butbul-Aviel Y, Koren A, Halevy R, et al: Procalcitonin as a diagnostic aid in osteomyelitis and septic arthritis. Pediatr Emerg Care 2005;21:828-832
68. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 1992;20:864-875
69. Rangel-Frausto MS, Pittet D, Costigan M, et al: The natural history of the systemic inflammatory response syndrome (SIRS): A prospective study. JAMA 1995;273:117-123
70. Nathens AB, Marshall JC: Sepsis, SIRS, and MODS: What's in a name? World J Surg 1996;20:386-391
71. Vincent JL: Dear SIRS, I'm sorry to say that I don't like you. Crit Care Med 1997;25:372-374
72. Levy MM, Fink MP, Marshall JC, et al: SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003;31:1250-1256
73. Giamarellos-Bourboulis EJ, Giannopoulou P, Grecka P, et al: Should procalcitonin be introduced in the diagnostic criteria for the systemic inflammatory response syndrome and sepsis? J Crit Care 2004;19:152-157
74. Chirouze C, Schuhmacher H, Rabaud C, et al: Low serum procalcitonin level accurately predicts the absence of bacteremia in adult patients with acute fever. Clin Infect Dis 2002;35:156-161
75. Casado-Flores J, Blanco-Quiros A, Asensio J, et al: Serum procalcitonin in children with suspected sepsis: A comparison with C-reactive protein and neutrophil count. Pediatr Crit Care Med 2003;4:190-195
76. Arkader R, Troster EJ, Lopes MR, et al: Procalcitonin does discriminate between sepsis and systemic inflammatory response syndrome. Arch Dis Child 2006;91:117-120
77. Clec'h C, Feniere F, Karoubi P, et al: Diagnostic and prognostic value of procalcitonin in patients with septic shock. Crit Care Med 2004;32:1166-1169
78. Von Lilenfeld-Toal M, Dietrich MP, Glasmacher A, et al: Markers of bacteremia in febrile neutropenic patients with hematological malignancies: procalcitonin and IL-6 are more reliable than C-reactive protein. Eur J Clin Microbiol Infect Dis 2004;23:539-544
79. Van Dissel JT: Procalcitonin: What should be its role in the clinical management of febrile patients admitted to the hospital. Clin Infect Dis 2003;36:824-825
80. Franz AR, Kron M, Pohlandt F, et al: Comparison of procalcitonin with interleukin 8, C-reactive protein and differential white blood cell count for the early diagnosis of bacterial infections in newborn infants. Pediatr Infect Dis J 1999;18:666-671
81. Dorizzi RM, Polati E, Sette P, et al: Procalcitonin in the diagnosis of inflammation in intensive care units. Clin Biochem 2006;10:1016
82. Gaini S, Koldkjaer, Pedersen C, et al: Procalcitonin, lipopolysaccharide binding protein, interleukin-6 and C-reactive protein in community-acquired infections and sepsis; a prospective study. Crit Care 2006;10: R53-R63
83. Hann YY, Doughty LA, Kofos D, et al: Procalcitonin is persistently increased among children with poor outcome from bacterial sepsis. Pediatr Crit Care Med 2003;4:21-25
84. Munoz P, Simarro N, Rivera M, et al: Evaluation of procalcitonin as a marker of infection in a nonselected sample of febrile hospitalized patients. Diagn Microbiol Infect Dis 2004;49:237-241
85. Jensen JU, Heslet L, Jensen TH, et al: Procalcitonin increase in early identification of critically ill patients at high risk of mortality. Crit Care Med 2006;34:2596-2602
86. Van Langevelde P, Joop K, van Loon J, et al: Endotoxin, cytokines, and procalcitonin in febrile patients admitted to the hospital: Identification of subjects at high risk of mortality. Clin Infect Dis 2000;31:1343-1348
87. Hryniewiecki T, Sitkiewicz D, Rawczynska-Englert I: [Role of procalcitonin in diagnosis of uncomplicated infective endocarditis.] Przegl Lek 2002;59:793-796
88. Balci C, Sungurtekin H, Curses E, et al: Usefulness of procalcitonin for diagnosis of sepsis in the intensive care unit. Crit Care 2003;7:85-90
89. Luzzani A, Polati E, Dorizzi R, et al: Comparison of procalcitonin and C-reactive protein as markers of sepsis. Crit Care Med 2003;31:1737-1741
90. Heper Y, Akalin EH, Mistik R, et al: Evaluation of serum C-reactive protein, procalcitonin, tumor necrosis factor alpha, and interleukin-10 levels as diagnostic and prognostic parameters in patients with community-acquired sepsis, severe sepsis, and septic shock. Eur J Clin Microbial Infect Dis 2006;481-491
91. Bell K, Wattie M, Byth K, et al: Procalcitonin: A marker of bacteraemia in SIRS. Anaesth Intensive Care 2003;31:629-636
92. Mitaka C: Clinical laboratory differentiation of infectious versus non-infectious systemic inflammatory response syndrome. Clin Chim Acta 2005;351:17-29
93. Ren J, Wu S: A burning issue: Do sepsis and systemic inflammatory response syndrome (SIRS) directly contribute to cardiac dysfunction? Front Biosci 2006;11:15-22
94. Mongan PD: Improving outcomes in septic shock: Can we define causality and find more efficacious treatments? Crit Care Med 2005;33:2034-2042
95. Sevransky JE, Levy MM, Marini JJ: Mechanical ventilation in sepsis-induced acute lung injury/acute respiratory distress syndrome: An evidence-based review. Crit Care Med 2004;32(11 Suppl):S548-S553
96. Parikh CR, Abraham E, Ancukiewicz M, et al: Urine IL-18 is an early diagnostic marker for acute kidney injury and predicts mortality in the intensive care unit. J Am Soc Nephrol 2005;16:3046-3052
97. Preiser JC, Devos P, Van den Berghe G: Tight control of glycaemia in critically ill patients. Curr Opin Clin Nutr Metab Care 2002;5:533-537 (Pubitemid 40684649)
98. Kinasewitz GT, Zein JG, Gregory L, et al: Prognostic value of a simple evolving disseminated intravascular coagulation score in patients with severe sepsis. Crit Care Med 2005;33:2214-2221
99. Arcaroli J, Fessler MB, Abraham E: Genetic polymorphisms and sepsis. Shock 2005;24:300-312
100. Abraham E: Alterations in cell signaling in sepsis. Clin Infect Dis 2005;41(Suppl 7): S459-S464
101. Müller B, Becker KL, Schächinger H, et al: Calcitonin precursors are reliable markers of sepsis in a medical intensive care unit. Crit Care Med 2000;28:977-983
102. Luyt CE, Guerin V, Combes A, et al: Procalcitonin kinetics as a prognostic marker of ventilator-associated pneumonia. Am J Respir Crit Care Med 2005;171:48-53
103. Carrol ED, Newland P, Thomson AP, et al: Prognostic value of procalcitonin in children with meningococcal sepsis. Crit Care Med 2005;33:224-225
104. Claeys R, Vinken S, Spapen H, et al: Plasma procalcitonin and C-reactive protein in acute septic shock: Clinical and biological correlates. Crit Care Med 2002;30:757-762
105. Dahaba AA, Hagara B, Fall A, et al: Procalcitonin for early prediction of survival outcome in postoperative critically ill patients with severe sepsis. Br J Anaesth 2006;97:503-508
106. Molnar Z, Bogar L: Lets go dynamic with procalcitonin. Crit Care Med 2006;34:2687-2688
107. Viallon A, Guyomarc'h P, Guyomarc'h S, et al: Decrease in serum procalcitonin levels over time during treatment of acute bacterial meningitis. Crit Care 2005;9: R344-R350
108. Schroeder J, Staubach KH, Zabel P, et al: Procalcitonin as a marker of severity in septic shock. Langenbecks Arch Surg 1999;384:33-38
109. Wunder C, Eichelbronner O, Roewer N: Are IL-6, IL-10 and PCT plasma concentrations reliable for outcome prediction in severe sepsis? A comparison with APACHE HI and SAPS II. Inflamm Res 2004;53:158-163
110. Meisner M, Tschaikowsky K, Palmaers T, et al: Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS. Crit Care 1999;3:45-50
111. Gibot S, Cravoisy A, Kolopp-Sarda MN, et al: Time-course of sTREM (soluble triggering receptor expressed on myeloid cells)-1, procalcitonin, and C-reactive protein plasma concentrations during sepsis. Crit Care Med 2005;33:792-796
112. Rintala EM, Aittoniemi J, Laine S, et al: Early identification of bacteremia by biochemical markers of systemic inflammation. Scand J Clin Lab Invest 2001;61:523-530
113. Giamarellou H, Giamarellos-Bourboulis EJ, Repoussis P, et al: Potential use of procalcitonin as a diagnostic criterion in febrile neutropenia: Experience from a multicentre study. Clin Microbiol Infect 2004;10:628-633
114. Kocazeybek B, Kucukoglu S, Ali Oner Y: Procalcitonin and C-reactive protein in infective endocarditis: Correlation with etiology and prognosis. Chemotherapy 2003;49:76-84
115. de Werra I, Jaccard C, Corradin SB, et al: Cytokines, nitrite/nitrate, soluble tumor necrosis factor receptors and procalcitonin concentrations: Comparisons in patients with septic shock, cardiogenic shock, and bacterial pneumonia. Crit Care Med 1997;25:607-613
116. Hatherill M, Jones G, Lim E, et al: Procalcitonin aids diagnosis of adrenal failure. Lancet 1998;351:1211-1212
117. Gendrel D, Raymond J, Coste J, et al: Comparison of procalcitonin with C-reactive protein, interleukin 6 and interferon-alpha for differentiation of bacterial vs. viral infections. Pediatr Infect Dis 1999;18:875-881 (Pubitemid 29487507)
118. Marc E, Menager C, Moulin F, et al: Procalcitonin et meningitis virales: Reduction des traitements antibiotiques inutiles par le dosage en routine au cours d'une epidemie. Arch Pediatr 2002;9:358-364
119. Shimetani N, Shimetani K, Mori M: Levels of three inflammation markers, C-reactive protein, serum amyloid A protein and procalcitonin, in the serum and cerebrospinal fluid of patients with meningitis. Scand J Clin Lab Invest 2001;61:567-574
120. Shimetani N, Shimetani K, Mori M: Clinical evaluation of the measurement of serum procalcitonin comparative study of procalcitonin and serum amyloid A protein in patients with high and low concentrations of serum C-reactive protein. Scand J Clin Lab Invest 2004;64:469-474
121. Petrikkos GL, Christofilopoulou SA, Tentolouris NK, et al: Value of measuring serum procalcitonin, C-reactive protein, and mannan antigens to distinguish fungal from bacterial infections. Eur J Clin Microbiol Infect Dis 2005;24:272-275
122. Charles PE, Dalle F, Aho S, et al: Serum procalcitonin measurement contribution to the early diagnosis of candidemia in critically ill patients. Intensive Care Med 2006;32:1577-1183
123. Christofilopoulou S, Charvalos E, Petrikkos G: Could procalcitonin be a predictive biological marker in systemic fungal infections? Study of 14 cases. Eur J Intern Med 2002;13:493-495
124. Distefano G, Cured R, Betta P, et al: Procalcitonin serum levels in perinatal bacterial and fungal infection of preterm infants. Acta Paediatr 2004;93:216-219
125. Takahashi K, Kita E, Konishi M, et al: Translocation model of Candida albicans in DBA-2/J mice with protein calorie malnutrition mimics hematogenous candidiasis in humans. Microb Pathog 2003;35:179-187
126. Hollenstein U, Looareesuwan S, Aichelburg A, et al: Serum procalcitonin levels in severe Plasmodium falciparum malaria. Am J Trop Med Hyg 1998;59:860-863
127. Chiwakata CB, Manegold C, Bonicke L, et al: Procalcitonin as a parameter of disease severity and risk of mortality in patients with Plasmodium falciparum malaria. J Infect Dis 2001;184:1091-1092
128. Braun N, Marfo Y, Von Gartner C, et al: CTLA-4 positive T cells in contrast to procalcitonin plasma levels discriminate between severe and uncomplicated Plasmodium falciparum malaria in Ghanaian children. Trop Med Int Health 2003;8:1018-1024
129. Davis TM, Assicot M, Bohuon C, et al: Serum procalcitonin in acute malaria. Trans R Soc Trop Med Hyg 1994;88:670-671
130. Keski Nisula L, Roponen M, Hirvonen MR, et al: Stimulated cytokine production correlates in umbilical arterial and venous blood at delivery. Eur Cytokine Netw 2004;15:347-352
131. Chiesa C, Panero A, Rossi N, et al: Reliability of procalcitonin concentrations for the diagnosis of sepsis in critically ill neonates. Clin Infect Dis 1998;27:1559-1561
132. Van Rossum AM, Wulkan RW, Oudesluys-Murphy AM: Procalcitonin as an early marker of infection in neonates and children. Lancet Infect Dis 2004;4:620-630
133. Casado-Flores J, Blanco-Quiros A, Nieto M, et al: Prognostic utility of the semiquantitative procalcitonin test, neutrophil count and C-reactive protein in meningococcal infection in children. Eur J Pediatr 2006;165:26-29
134. Kitanovski L, Jazbec J, Hojker S, et al: Diagnostic accuracy of procalcitonin and interleukin-6 values for predicting bacteremia and clinical sepsis in febrile neutropenic children with cancer. Eur J Clin Microbiol Infect Dis 2006;25:413-415
135. Strejewski GR, Nylen ES, Bell MJ, et al: Interleukin-6, interleukin-8, and a rapid and sensitive assay for calcitonin precursors for the determination of bacterial sepsis in febrile neutropenic children. Pediatr Crit Care Med 2005;6:129-135
136. Lee YJ, Park CH, Yun JW, et al: Predictive comparisons of procalcitonin (PCT) level, arterial ketone body ratio (AKBR), APACHE III score and multiple organ dysfunction score (MODS) in systemic inflammatory response syndrome (SIRS). Yonsei Med 2004;45:29-37
137. Egger G, Aigner R, Glasner A, et al: Blood polymorphonuclear leukocyte migration as a predictive marker for infections in severe trauma: Comparison with various inflammation parameters. Intensive Care Med 2004;30:331-334
138. Puri VK: Scoring systems: Is a fix needed? Crit Care Med 2005;33:894-895
139. Chan YL, Tseng CP, Tsay PK, et al: Procalcitonin as a marker of bacterial infection in the emergency department: An observational study. Crit Care 2004;8: R12-R20
140. Simon L, Gauvin F, Amre DK, et al: Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: A systematic review and meta-analysis. Clin Infect Dis 2004;39:206-217
141. Knudsen TB, Kristiansen TB: Issues pertaining to data extraction and classification and publication bias in meta-analysis of the diagnostic accuracy of markers for bacterial infection. Clin Infect Dis 2005;40:1372-1373; author reply 1373-1374
142. Kofoed K, Andersen O, Kronborg G, et al: Use of plasma C-reactive protein, procalcitonin, neutrophils, macrophage migration inhibitory factor, soluble urokinase-type plasminogen activator receptor, and soluble triggering receptor expressed on myeloid cells-1 in combination to diagnose infections: A prospective study. Crit Care 2007;11: R38 [Epub ahead of print]
143. Levy MM: The electrocardiogram for sepsis: How close are we? Crit Care 2007;11:144 [Epub ahead of print]
144. Tang BM, Eslick GD, Craig JC, et al: Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: Systematic review and meta-analysis. Lancet Infect Dis 2007;7:210-217
145. Steinbach G, Rau B, Debard AL, et al: Multicenter evaluation of a new immunoassay for procalcitonin measurement on the Kryptor system. Clin Chem Lab Med 2004;42:440-449
146. Christ-Crain M, Jaccard-Stolz D, Bingisser R, et al: Effect of procalcitonin-guided therapy on antibiotic use and outcome in lower respiratory tract infections: Cluster-randomised single-blinded intervention trial. Lancet 2004;363:600-607
147. Briel M, Christ-Crain M, Young J, et al: Procalcitonin-guided antibiotic use versus a standard approach for acute respiratory tract infections in primary care: Study protocol for a randomized controlled trial and baseline characteristics of participating general practitioners. BMC Fam Pract 2005;6:34
148. Stolz D, Christ-Crain M, Bingisser R, et al: Antibiotic treatment of exacerbations of COPD: A randomized, controlled trial comparing procalcitonin-guidance with standard therapy. Chest 2007;131:9-19
149. Chua AP, Lee KH: Procalcitonin in severe acute respiratory syndrome (SARS). J Infect 2004;48:303-306
150. Schleicher GK, Herbert V, Brink A, et al: Procalcitonin and C-reactive protein levels in HIV-positive subjects with tuberculosis and pneumonia. Eur Respir J 2005;25:688-692
151. Manciani V, Weiss S, Dauber A, et al: Utility of procalcitonin to identify young febrile infants at risk of serious bacterial infections. Acad Emerg Med 2007;14:588
152. Herrlinger KR, Dittman R, Weitz G, et al: Serum procalcitonin differentiates inflammatory bowel disease and self-limited colitis. Inflamm Bowel Dis 2004;10:229-233
153. Korczowski B, Szybist W: Serum procalcitonin and C-reactive protein in children with diarrhea of various aetiologies. Acta Paediatr 2004;93:169-173
154. Kafetzis DA, Velissariou IM, Nikolaides P, et al: Procalcitonin a predictor of severe appendicitis in children. Eur J Clin Microbiol Infect Dis 2005;24:484-487
155. Laifer G, Wasner M, Sendi P, et al: Dynamics of serum procalcitonin in patients after major neurosurgery. Clin Microbiol Infect Dis 2005;11:679-681
156. Pihusch M, Pihusch R, Fraungerger P, et al: Evaluation of C-reactive protein, interleukin-6, and procalcitonin levels in allogeneic hematopoietic stem cell recipients. Eur J Haematol 2006;76:93-101
157. Puder JJ, Vargas S, Kraenzlin M, et al: Central fat excess in polycystic ovary syndrome: Relation to low grade inflammation and insulin resistance. J Clin Endocrinol Metab 2005;90:6014-6021
158. Ilhan F, Akbulut H, Karaca I, et al: Procalcitonin C-reactive protein and neopterin levels in patients with coronary atherosclerosis. Acta Cardiol 2005;60:361-365
159. Marchini G, Berggren V, Djilali-Merzoug R, et al: The birth process initiates an acute phase reaction in the fetus-newborn infant. Acta Paediatr 2000;89:1082-1086
160. Llorente E, Prieto B, Cardo L, et al: Umbilical cord blood serum procalcitonin by Time-Resolved Amplified Cryptate Emission (TRACE) technology: Reference values of a potential marker of vertically transmitted neonatal sepsis. Clin Chem Lab Med 2007;45:1531-1535
161. Tavares E, Maldonado R, Minano FJ: N-procalcitonin: Central effects on feeding and energy homeostasis in rats. Endocrinology 2007;148:1891-1901
162. Liappis AP, Gibbs KW, Yoon B, et al: Human leukocyte and whole blood cytokine response to exogenous procalcitonin. Presented at: The 89th Endocrine Society Meeting, Toronto, June 2007, abstract P1-367
163. Sexton PM, Christopoulos G, Christopoulos A, et al: Procalcitonin has bioactivity at calcitonin receptor family complexes: Potential mediator implications in sepsis. Crit Care Med In Press
164. Suffredini AF, Hochstein HD, McMahon FG: Dose-related inflammatory effects of intravenous endotoxin in humans: Evaluation of a new clinical lot of Escherichia coli O:113 endotoxin. J Infect Dis 1999;179:1278-1282