Serum Calcitonin May Be a Marker for Inhalation Injury in Burns

O’Neill, William; Jordan, Marion H.; Lewis, Mark S.; Snider, Richard H.; Moore, Charles F.; Becker, Kenneth L.

doi:10.1097/00004630-199211000-00001

Cited by 27 publications

(9 citation statements)

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Section: Discussionmentioning

confidence: 99%

“…Nevertheless, in that study, BCs were not collected, and the final diagnosis of sepsis was made on clinical features, laboratory findings and imaging tests. Shozushima et al (2011) found presepsin superior to PCT in discriminating between SIRS and sepsis in a population of 41 septic patients, with~30 % of cases of severe burns and multiple trauma, conditions in which, in the early stage of traumatic insult, PCT does not increase in an infection-specific manner (O'Neill et al, 1992;Wanner et al, 2000).However, in a multicentre prospective study in ED patients, PCT diagnostic accuracy in the recognition of sepsis and severe sepsis/septic shock, diagnosed according to the Surviving Sepsis Campaign Criteria (Dellinger et al, 2013), was superior to that of presepsin, although presepsin retained a significant prognostic role and closely correlated with inhospital mortality of septic patients (Ulla et al, 2013). Differently from our study, the role of presepsin in predicting positive BC was not evaluated.…”

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confidence: 99%

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Diagnostic accuracy of presepsin (sCD14-ST) and procalcitonin for prediction of bacteraemia and bacterial DNAaemia in patients with suspected sepsis

Leli

Ferranti

Marrano

et al. 2016

Journal of Medical Microbiology

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Early diagnosis and prompt targeted therapy are essential for septic patients' outcome. Procalcitonin (PCT) has been shown to predict bacteraemia and bacterial DNAaemia. Presepsin, the circulating soluble form of CD14 subtype, increases in response to bacterial infections, and is considered a new, emerging, early marker for sepsis. We evaluated the diagnostic accuracy of presepsin in predicting bacteraemia and bacterial DNAaemia in 92 patients with suspected sepsis, and we compared it with that of PCT and C-reactive protein (CRP). Presepsin median values were significantly higher in bacteraemic vs non-bacteraemic patients [1290 pg ml .07, respectively). Both biomarkers performed significantly better than CRP, which had an AUC for bacteraemia of 0.602 and for DNAaemia of 0.632 (all P values <0.05). In conclusion, in patients with suspected sepsis, presepsin and PCT showed a good diagnostic accuracy in predicting both bacteraemia and bacterial DNAaemia, superior to CRP. INTRODUCTIONSepsis, a systemic deleterious host response to infection that leads to organ dysfunction (Dellinger et al., 2013), is a major cause of morbidity and mortality (Mayr et al., 2014). Early diagnosis and prompt targeted therapy are essential for patients' outcome (Kumar et al., 2006).Blood culture (BC) is the gold standard for pathogen detection, although false-negative results, especially in antibiotic pre-treated patients, can occur (Opota et al., 2015). New approaches to speed sepsis diagnosis include molecular assays and the use of specific biomarkers (Reinhart et al., 2012). Molecular technologies, allowing a rapid detection of microbial DNA, could represent an important additional tool for the aetiological diagnosis of bloodstream infections, particularly in antibiotic pre-treated patients (Dark et al., 2015;Mongelli et al., 2015;Pasqualini et al., 2012). Indeed, real-time PCR (RT-PCR) can detect not only viable microorganisms in patient's blood (bacteraemia) but also circulating bacterial DNA (DNAaemia) that persists for several days in blood during antimicrobial treatment or may be released into the bloodstream from the primary infectious foci (Øvstebø et al., 2004;Navarro et al., 2006;Peters et al., 2007).During recent years, many biomarkers have been evaluated and compared to find the best predictor of sepsis (Cho & Choi, 2014). Procalcitonin (PCT) has been identified as having a good diagnostic accuracy for predicting bacteraemia and pathogen DNAaemia in different clinical settings (Koivula et al., 2011;Mencacci et al., 2012), representing an advance over C-reactive protein (CRP) (Barati et al., 2008;Leli et al., 2014;Yu et al., 2010 Rabensteiner et al., 2014;Romualdo et al., 2014;Shozushima et al., 2011).To the best of our knowledge, no study described presepsin diagnostic accuracy in predicting both bacteraemia and bacterial DNAaemia, which was the first aim of this study.The second aim was to compare the diagnostic accuracy of presepsin with that of PCT and CRP. METHODSPatients and samples. This prospective observational stud...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Diagnostic accuracy of presepsin (sCD14-ST) and procalcitonin for prediction of bacteraemia and bacterial DNAaemia in patients with suspected sepsis

Leli

Ferranti

Marrano

et al. 2016

Journal of Medical Microbiology

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“…Increased PCT concentrations have been reported in the sera of patients with inhalational injury in burns, 12,19 pulmonary aspiration, 20 pancreatitis, 21 heat stroke, 22 and mesenteric infarction. 53 It is not completely understood why PCT levels increase in these noninfectious inflammatory conditions.…”

Section: Noninfectious Systemic Inflammationmentioning

confidence: 99%

“…16 Shortly thereafter, it was demonstrated that precursors of calcitonin, including PCT, were also elevated in the serum of patients with neuroendocrine tumors and could be used equally well as serum markers of cancer. 17,18 In the 1990s, increased PCT concentrations were noted in the sera of patients with severe systemic inflammatory conditions including inhalational injury in burns, 12,19 pulmonary aspiration, 20 pancreatitis, 21 and heat stroke. 22 Similar elevations in serum PCT were observed after severe mechanical trauma 23 and extensive surgery.…”

Section: Historical Backgroundmentioning

confidence: 99%

Procalcitonin as a Marker of Severe Bacterial Infection in Children in the Emergency Department

Deis¹,

Creech²,

Estrada³

et al. 2010

Pediatric Emergency Care

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Procalcitonin, the prohormone of calcitonin, is a relatively new and innovative marker of bacterial infection that has multiple potential applications in the pediatric emergency department. In healthy individuals, circulating levels of procalcitonin are generally very low (<0.05 ng/mL), but in the setting of severe bacterial infection and sepsis, levels can increase by hundreds to thousands of fold within 4 to 6 hours. Although the exact physiologic function of procalcitonin has not been determined, the consistent response and rapid rise of this protein in the setting of severe bacterial infection make procalcitonin a very useful biomarker for invasive bacterial disease. In Europe, serum procalcitonin measurements are frequently used in the diagnosis and the management of patients in a variety of clinical settings. To date, the use of procalcitonin has been limited in the United States, but this valuable biomarker has many potential applications in both the pediatric emergency department and the intensive care unit. The intent of this article is to review the history of procalcitonin, describe the kinetics of the molecule in response to bacterial infection, describe the laboratory methods available for measuring procalcitonin, examine the main causes of procalcitonin elevation, and evaluate the potential applications of procalcitonin measurements in pediatric patients.

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“…This observation suggests an extratumoral source of calcitonin secretion. Conditions as diverse as chronic renal failure, chronic pulmonary disease, acute trauma and inhalation injury may lead to hypercalcitoninaemia [6,7,8,9,10,11]. With the exception of patient 6, who was excluded because of chronic renal failure and increased parathyroid hormone levels, none of the remaining five non-MTC patients had evidence of impaired renal function.…”

Section: Discussionmentioning

confidence: 99%

Differential diagnosis of calcitonin-secreting neuroendocrine carcinoma of the foregut by pentagastrin stimulation

Machens

Haedecke

Holzhausen

et al. 2000

Langenbeck's Arch Surg

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Serum Calcitonin May Be a Marker for Inhalation Injury in Burns

Cited by 27 publications

References 0 publications

Diagnostic accuracy of presepsin (sCD14-ST) and procalcitonin for prediction of bacteraemia and bacterial DNAaemia in patients with suspected sepsis

Diagnostic accuracy of presepsin (sCD14-ST) and procalcitonin for prediction of bacteraemia and bacterial DNAaemia in patients with suspected sepsis

Procalcitonin as a Marker of Severe Bacterial Infection in Children in the Emergency Department

Differential diagnosis of calcitonin-secreting neuroendocrine carcinoma of the foregut by pentagastrin stimulation

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