Serum procalcitonin levels in severe Plasmodium falciparum malaria.

Abstract

Abstract. Levels of procalcitonin (ProCT) have been found to be elevated in individuals with severe bacterial infections such as sepsis and peritonitis, and this correlates well with the severity of the disease. Recently, increased levels have been described in melioidosis and Plasmodium falciparum malaria. In this study ProCT levels were measured in 27 Thai patients with complicated malaria before and during/after treatment with artesunate and mefloquine. Initial parasite counts averaged 290,680/l (range ϭ 533-1,147,040). On admission, ProCT levels were elevated in all but one patient (median ϭ 40 ng/ml, range ϭ 0.04-662, normal values Ͻ 0.5 ng/ml). With treatment, levels decreased to 1.3 ng/ml (range ϭ 0.01-6.5). Nitrite/nitrate levels in patients were higher than in controls throughout the study. The ProCT levels correlated with initial parasite density (P Ͻ 0.05), which is a marker of disease severity, and with nitrite/nitrate levels (P Ͻ 0.05). Based on the changes of ProCT levels over the course of the disease a possible role in the acute-phase reaction seems likely.

Detection and quantitation of forty eight cytokines, chemokines, growth factors and nine acute phase proteins in healthy human plasma, saliva and urine

“…Measured concentrations of nine acute phase proteins were within the reported normal healthy ranges in plasma, saliva and urine. Normal ranges for healthy subjects were reported as follows: ferritin < 200 μg/ml for males and < 150 μg/ml for females [84]; fibrinogen 3 μg/ml [85]; procalcitonin < 5 ng/ml [86]; serum amyloid A 20 μg/ml [87]; tissue plasminogen activator 3.7 ng/ml [88]; C-reactive proteins is <10 ng/ml and it increases with aging [89,90]; alpha-2 macroglobulin 2.6 μg/ml [85]; serum amyloid P 33 μg/ml [91]; and haptoglobin 0.3 to 2 mg/ml [92]. Although concentrations of alpha-2 macroglobulin and haptoglobin in some volunteers were over the detection limit in plasma (in saliva and urine were within the detection limit ranges) it can be anticipated that both proteins would be within the normal healthy range as all other seven acute phase proteins of those volunteers were within the healthy normal ranges.…”

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

“…Although the range is wide, values as high as 662 ng/mL have been reported (126). Although some authors note a significant positive correlation with severity (126,127), others find no correlation (128).…”

Procalcitonin as a Parameter of Disease Severity and Risk of Mortality in Patients withPlasmodium falciparumMalaria

“…Enthusiasm has been triggered by a nearly exponential increase of both retrospective and prospective studies that consistently have documented elevated serum concentrations of PCT in various severe bacterial or parasitic infections, such as sepsis [1], pyelonephritis [2], melioidosis, disseminated candidiasis, pneumonitis [3], and pulmonary tuberculosis [4]. Reports of elevated serum concentrations of PCT in patients with falciparum malaria have been of particular interest [5][6][7][8]. However, these studies lack sufficient information on adult and nonimmune patients and follow-up data.…”