Procalcitonin increase after anti-CD3 monoclonal antibody therapy does not indicate infectious disease

Kuse, E. R.; Jaeger, K.

doi:10.1007/s001470050744

Cited by 11 publications

(18 citation statements)

References 3 publications

(2 reference statements)

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“…However, as mentioned above, steroids and commonly used immunosuppressant drugs do not interfere with PCT metabolism. None of the study centres used OKT-3, the only immunosuppressant known to interfere with PCT production and secretion [35]. Finally, the biomarkers were measured in real time and the results were available to the clinicians treating the patients.…”

Section: Discussionmentioning

confidence: 99%

Role of biomarkers in early infectious complications after lung transplantation

et al. 2017

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BackgroundInfections and primary graft dysfunction are devastating complications in the immediate postoperative period following lung transplantation. Nowadays, reliable diagnostic tools are not available. Biomarkers could improve early infection diagnosis.MethodsMulticentre prospective observational study that included all centres authorized to perform lung transplantation in Spain. Lung infection and/or primary graft dysfunction presentation during study period (first postoperative week) was determined. Biomarkers were measured on ICU admission and daily till ICU discharge or for the following 6 consecutive postoperative days.ResultsWe included 233 patients. Median PCT levels were significantly lower in patients with no infection than in patients with Infection on all follow up days. PCT levels were similar for PGD grades 1 and 2 and increased significantly in grade 3. CRP levels were similar in all groups, and no significant differences were observed at any study time point. In the absence of PGD grade 3, PCT levels above median (0.50 ng/ml on admission or 1.17 ng/ml on day 1) were significantly associated with more than two- and three-fold increase in the risk of infection (adjusted Odds Ratio 2.37, 95% confidence interval 1.06 to 5.30 and 3.44, 95% confidence interval 1.52 to 7.78, respectively).ConclusionsIn the absence of severe primary graft dysfunction, procalcitonin can be useful in detecting infections during the first postoperative week. PGD grade 3 significantly increases PCT levels and interferes with the capacity of PCT as a marker of infection. PCT was superior to CRP in the diagnosis of infection during the study period.

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Section: Discussionmentioning

confidence: 99%

Role of biomarkers in early infectious complications after lung transplantation

et al. 2017

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“…21,22 However, the specificity of PCT is diminished by the fact that PCT is also elevated in clinical scenarios with systemic noninfectious inflammation as in burn trauma, 23 heat shock, 24 or after administration of anti-lymphocyte globulin. 10,25,26 Cardiac surgery with cardiopulmonary bypass causes a generalized inflammatory response syndrome; therefore high serum lev- els of PCT have also been shown in these patients in the absence of infection. 7,9,[27][28][29][30][31] Franke et al 13 reported higher PCT levels in patients after on-pump coronary artery bypass grafting than in those after off-pump coronary artery bypass surgery.…”

Section: Discussionmentioning

confidence: 99%

Kinetic of Procalcitonin in the Early Postoperative Course Following Heart Transplantation

Madershahian

Wittwer

Strauch

et al. 2008

Journal of Cardiac Surgery

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PCT levels have been consistently low (<10 ng/mL) in patients with an uneventful course, but more frequently increased in patients with postoperative complications and even associated with an increased mortality early postoperatively when values exceed 80 ng/mL. As a clinical consequence, PCT levels in the first few days following cardiac transplantation can help to identify patients at risk, when concentrations exceed the "normal" posttransplant range.

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“…In the last decade, there has been growing evidence that treatment with monoclonal and polyclonal antibodies can upregulate plasma PCT concentrations . Similarly, high PCT levels were found in allogeneic stem cell transplant recipients after antilymphocyte antibody administration .…”

Section: Effect Of Induction Therapy On the Dynamic Of Procalcitoninmentioning

confidence: 99%

“…In a group of liver transplant recipients, ATG administration was associated with high peak PCT concentrations on post‐operative day 1 (median 53 ng/mL, range 7.9–249.1 ng/mL) when compared to those who did not receive ATG; subsequent ATG doses did not elicit further PCT elevations and levels decreased . In a study of liver transplant recipients treated with OKT3 for steroid‐refractory rejection, plasma PCT levels increased from 1.05 ± 0.45 ng/mL (prior to antibody administration) to 12.1 ± 6.4 ng/mL (24 h after antibody administration) . Treatment with OKT3 for acute rejection has also resulted in elevations of PCT in renal transplant recipients .…”

Section: Effect Of Induction Therapy On the Dynamic Of Procalcitoninmentioning

confidence: 99%

“…In solid organ transplantation (SOT) recipients, the kinetics of PCT may be affected by several factors including recent surgical procedures, presence of underlying end‐organ disease, maintenance immunosuppression and type of immunosuppressive agents, making its use and interpretation more complex than in non‐transplant patients . In this article, we review the published evidence regarding the use of PCT in SOT with the aim to differentiate infectious vs. non‐infectious syndromes post‐transplantation, rejection from infection, and colonization from infection.…”

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confidence: 99%

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The use and value of procalcitonin in solid organ transplantation

Sandkovsky

Kalil

Florescu

2015

Clinical Transplantation

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Procalcitonin (PCT) has been increasingly used as a biomarker of bacterial infection and as a tool to guide antimicrobial therapy, especially in lower respiratory tract and bloodstream infections. Despite its increased use, data in patients with solid organ transplants are limited. Even without the presence of infection, PCT increases as a result of surgical procedures during transplantation, implantation of devices, and use of induction immunosuppressive therapy. The risk of infection is also higher in solid organ transplant recipients when compared to the general population. Monitoring PCT in the early post-transplant period seems to be a promising method for early detection of infectious complications. It has been shown that elevated PCT levels after one wk of transplantation are correlated with infectious complications. PCT may be a useful adjunctive biomarker that may improve early identification and guide appropriate treatment of infection or rejection, with the potential to further improve clinical outcomes. The use of serial PCT measurements may be more reliable than single values. It is important to recognize which factors may lead to PCT increases in the post-transplantation period, which in turn will help understand the kinetics and utility of this biomarker in this important patient population.

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Procalcitonin increase after anti-CD3 monoclonal antibody therapy does not indicate infectious disease

Cited by 11 publications

References 3 publications

Role of biomarkers in early infectious complications after lung transplantation

Role of biomarkers in early infectious complications after lung transplantation

Kinetic of Procalcitonin in the Early Postoperative Course Following Heart Transplantation

The use and value of procalcitonin in solid organ transplantation

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