An Unrecognized Cause of Elevated Procalcitonin Level

Area of Science:

• Endocrinology
• Clinical Biochemistry

Background:

• Diabetic ketoacidosis (DKA) is a severe diabetes complication.
• Procalcitonin (PCT) is a biomarker for bacterial infections, but elevated levels can occur in DKA without infection.

Observation:

• A 31-year-old male presented with DKA and elevated PCT levels.
• Extensive tests, including blood and urine cultures, ruled out bacterial infection.

Findings:

• The patient received DKA treatment (hydration, insulin) without antibiotics.
• PCT levels decreased following DKA management, indicating a non-infectious cause for elevation.

Implications:

• Elevated PCT in DKA may not always indicate bacterial infection.
• Further research is needed to understand non-infectious inflammation's role in PCT elevation during DKA.
• Clinical context is crucial for interpreting PCT levels in DKA patients to avoid unnecessary antibiotics.