Serum procalcitonin and C-reactive protein in children with diarrhoea of various aetiologies
Related Experiment Video
Updated: Aug 4, 2026
A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
Published on: June 15, 2018
1Department of Pediatrics and Pediatric Gastroenterology, District Hospital No. 2, University of Rzeszów, Poland. bartosz@uw.rzeszow.pl
Insights
Procalcitonin (PCT) is a better indicator than C-reactive protein (CRP) for identifying systemic bacterial infections in children with diarrhea. While PCT is more specific, it is less sensitive for differentiating bacterial from non-bacterial causes of inflammation.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Biochemistry
- Diagnostic Biomarkers
Background:
- Acute-phase reactants like procalcitonin (PCT) and C-reactive protein (CRP) are used to assess inflammation.
- Their distinct clinical profiles necessitate a comparison of their diagnostic utility in pediatric gastroenteritis.
Purpose of the Study:
- To compare the diagnostic accuracy of serum PCT and CRP levels in identifying the cause and severity of inflammation in hospitalized children with diarrhea.
- To evaluate PCT and CRP as biomarkers for differentiating bacterial infections from other causes of pediatric diarrhea.
Main Methods:
- Serum PCT and CRP concentrations were measured in 129 children hospitalized with diarrhea.
- Children were categorized into groups based on diagnosis: systemic bacterial infection (sepsis/meningitis), bacterial enterocolitis, rotaviral enterocolitis, and inflammatory bowel disease (IBD).
- A control group of 30 healthy children was included for comparison.
Main Results:
- PCT was elevated (>0.5 ng/mL) in 100% of children with systemic bacterial infection, compared to 61% with bacterial enterocolitis, 7% with rotaviral enterocolitis, and 23% with IBD.
- CRP was elevated (>2 mg/dL) in 89% of children with systemic bacterial infection, 61% with bacterial enterocolitis, 19% with rotaviral enterocolitis, and 46% with IBD.
- PCT and CRP levels were low in healthy controls.
Conclusions:
- Procalcitonin (PCT) demonstrated higher reliability than C-reactive protein (CRP) in diagnosing systemic bacterial infections in pediatric diarrhea.
- PCT exhibited greater specificity but lower sensitivity in distinguishing between bacterial and non-bacterial etiologies of inflammation.
Aim:
Procalcitonin (PCT) and C-reactive protein (CRP) are two acute-phase reactants with different clinical features. The study aimed to compare the diagnostic value of admission serum PCT and CRP concentrations as indicators of aetiology and intensity of inflammation in children hospitalized with diarrhoea.
Methods:
Serum PCT and CRP concentrations were determined on admission in 129 children hospitalized with diarrhoea. They were divided into four groups: group A: 37 children with diarrhoea as one of symptoms of ongoing systemic bacterial infection (sepsis/ meningitis): group B: 36 children with bacterial enterocolitis; group C: 43 children with rotaviral enterocolitis; and group D: 13 children with active inflammatory bowel disease (IBD). For comparison serum PCT and CRP concentrations were determined in 30 healthy controls.
Results:
PCT concentration was > 0.5 ng ml(-1) in all 37 (100%) children with diarrhoea and systemic bacterial infection (mean 18.5 +/- 3.2 ng ml(-1)) and CRP was above 2 mg dl(-1) in 33 (89%) of these children (11.7 +/- 1.5 mg dl(-1)). PCT concentration was > or = 0.5 ng ml(-1) in 22 of 36 (61%) children with bacterial enterocolitis (2.2 +/- 0.6 ng ml(-1)), in 3 of 43 (7%) children with rotaviral infection (0.2 +/- 0 ng ml(-1)) and in 3 of 13 (23%) patients with IBD (0.3 +/- 0.1 ng ml(-1)). CRP value was > or =2 mg dl(-1) in 22 (61%) children from group B (5.4 +/- 1.0 mg dl(-1)), in 8 (19%) children from group C (l.3 +/- 0.3 mg dl(-1)) and in 6 (46%) patients from group D (3.3 +/- 0.9 mg dl(-1)). In the control group the PCT (0.1 +/- 0.1 ng ml(-1)) and CRP (0.03 +/- 0.1 mg dl(-1)) levels were low or undetectable.
Conclusion:
In this study PCT was a more reliable marker than CRP of systemic bacterial infection in children with diarrhoea. PCT was more specific but less sensitive in the differentiation of bacterial and non-bacterial aetiology of inflammation.
Related Concept Videos
01:30Pneumonia III: Complications and Assessment
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
01:30Serum Laboratory Studies, Stool Test, Breath Test
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...