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Titolo:
Procalcitonin-reduced sensitivity and specificity in heavily leucopenic and immunosuppressed patients
Autore:
Svaldi, M; Hirber, J; Lanthaler, AI; Mayr, O; Faes, S; Peer, E; Mitterer, M;
Indirizzi:
Reg Hosp Bozen, Dept Haematol, Bolzano, Italy Reg Hosp Bozen Bolzano Italy Hosp Bozen, Dept Haematol, Bolzano, Italy Gen Hosp Meran, Meran, Italy Gen Hosp Meran Meran ItalyGen Hosp Meran, Meran, Italy Reg Hosp Bozen, Dept Anaesthesiol, Bolzano, Italy Reg Hosp Bozen BolzanoItaly p Bozen, Dept Anaesthesiol, Bolzano, Italy Reg Hosp Bozen, Microbiol Lab, Bolzano, Italy Reg Hosp Bozen Bolzano Italy Hosp Bozen, Microbiol Lab, Bolzano, Italy Reg Hosp Bozen, Cent Lab, Bolzano, Italy Reg Hosp Bozen Bolzano ItalyReg Hosp Bozen, Cent Lab, Bolzano, Italy
Titolo Testata:
BRITISH JOURNAL OF HAEMATOLOGY
fascicolo: 1, volume: 115, anno: 2001,
pagine: 53 - 57
SICI:
0007-1048(200110)115:1<53:PSASIH>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
C-REACTIVE PROTEIN; SERUM PROCALCITONIN; IN-VITRO; BACTERIAL; SEPSIS; INTERLEUKIN-8; INFECTIONS; ADULTS; ALPHA; PHASE;
Keywords:
PCT leucopenia; bacteraemia; sepsis; septic shock;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Mitterer, M Transfus Med, Rossinistr 5, I-39012 Meran, Italy Transfus Med Rossinistr 5 Meran Italy I-39012 12 Meran, Italy
Citazione:
M. Svaldi et al., "Procalcitonin-reduced sensitivity and specificity in heavily leucopenic and immunosuppressed patients", BR J HAEM, 115(1), 2001, pp. 53-57

Abstract

Procalcitonin (PCT) has proven to be a very sensitive marker of sepsis fornon-leucopenic patients. Little is known about its relevance in immunosuppressed and leucopenic adults. Four hundred and seventy-five PCT determinations were carried out in 73 haematological patients: on 221 occasions the white blood cell (WBC) count was <1.0 x 10(9)/l and on 239 occasions it was >1.0 x 10(9)/l leucocytes. Patients were classified as: nonsystemic infected controls (n = 280), patients with bacteraemia (n = 32), sepsis (n = 30), severe sepsis (n = 3), septic shock (n = 3) and systemic inflammatory response syndrome (SIRS) (n = 62). When the WBC count was > 1.0 x 10(9)/l, gram-negative bacteria induced higher PCT levels (median 9.4 ng/ml) than gram-positives (median 1.4 ng/ml). In cases with a WBC < 1.0 x 10(9)/l, PCT levelswere similar for gram-negative and gram-positive bacteria (1.1 ng/ml versus 0.85 ng/ml). Regardless of the leucocyte count, the median PCT level in bacteraemia cases always remained < 0.5 ng/mL In heavily leucopenic situations, PCT levels were never > 2 ng/ml even in the sepsis and severe sepsis/septic shock groups, whereas a WBC count > 1.0 x 10(9)/l resulted in median PCT values of 4.1 ng/ml and 45 ng/ml respectively. The positive predictive value for sepsis (cut-off 2 ng/ml) was 93% in cases of WBC count > 1.0 x 10(9)/l, but only 66% in leucopenic conditions. The negative predictive value (cut-off 0.5 ng/ml) was 90% when the WBC count was > 1.0 x 10(9)/l and 63% in leucopenic conditions, Procalcitonin is an excellent sepsis marker with a high positive- and negative-predictive value in patients with WBC count >1.0 x 10(9)/l, but it does not work satisfactorily below this leucocyte count.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 08/08/20 alle ore 08:54:36