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Discrepancies between plasma procalcitonin and C-reactive protein levels are common in acute illness

Lauri Ivaska1, Varpu Elenius1, Ilkka Mononen2,3

  • 1Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland.

Acta Paediatrica (Oslo, Norway : 1992)
|December 9, 2015
PubMed

Insights

Discrepancies between procalcitonin (PCT) and C-reactive protein (CRP) occurred in 29% of hospitalized children. PCT may be more advantageous than CRP in diagnosing bacteremia, even when bacterial infection is absent.

Area of Science:

  • Biochemistry
  • Clinical Medicine
  • Pediatrics

Background:

  • Procalcitonin (PCT) and C-reactive protein (CRP) are key biomarkers for bacterial infections.
  • These biomarkers possess distinct clinical utility in infection diagnosis.
  • Understanding discrepancies between PCT and CRP is crucial for accurate patient management.

Purpose of the Study:

  • To investigate the incidence of discrepancies between plasma PCT and CRP levels in hospitalized children.
  • To analyze the clinical significance and implications of these biomarker level differences.

Main Methods:

  • Retrospective analysis of 635 simultaneous PCT and CRP measurements from a single center.
  • Comparison of clinical characteristics, microbiological findings, and diagnoses between groups with discordant PCT and CRP levels.

Main Results:

  • Discrepancies between PCT and CRP were observed in 29% of the cases studied.
  • Elevated PCT with low CRP was linked to hypoxia, hemodynamic stress, and bacteremia.
  • Elevated CRP with low PCT correlated with focal bacterial infections, inflammatory conditions, and postoperative settings.
  • Diabetic ketoacidosis showed a strong association with markedly elevated PCT levels.

Conclusions:

  • Discrepancies in PCT and CRP levels are common in acutely ill children (29%).
  • While both biomarkers can elevate without bacterial infection, PCT shows potential advantages in diagnosing bacteremia.
  • PCT may provide superior diagnostic value compared to CRP in specific pediatric critical care scenarios.
Abstract

Keywords:
BacteraemiaC-reactive proteinKetoacidosisProcalcitoninSerious bacterial infection

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