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What is Procalcitonin test? 

Procalcitonin is a protein produced by the body in response to tissue injury and bacterial infections. High levels of this compound could be an indication of sepsis or severe bacterial infection. This test looks for changes in levels of procalcitonin in your bloodstream to assess if you have either of the above-mentioned conditions. 

Every time you get an infection, your immune system tries to keep it at a single location so it doesn’t spread through the body. However, sometimes pathogenic bacteria slip through the immune system and enter the bloodstream, leading to a condition known as bacteraemia. Bacteraemia triggers a serious and sometimes life-threatening immune response called sepsis. If left untreated, sepsis can lead to organ failure and death.

Procalcitonin levels may also rise in a few other conditions - though they are not as high as in sepsis. These include tissue damage that may occur with:

Non-infectious inflammatory conditions:

  • Autoimmune disorders
  • Chronic inflammatory processes
  1. Why is a Procalcitonin test performed?
  2. How do you prepare for a Procalcitonin test?
  3. How is a Procalcitonin test performed?
  4. Procalcitonin test results and normal range

Doctors order a procalcitonin test:

  • To diagnose sepsis and bacterial infections like meningitis
  • To look for kidney damage in children with urinary tract infections
  • To determine the severity of sepsis
  • To determine if the cause of infection is bacterial
  • To monitor the efficacy of antibiotic treatment
  • To check for the development of a secondary bacterial infection in people with tissue damage due to trauma, surgery or non-bacterial infections

This test may also be ordered to seriously ill people who show the following symptoms of sepsis:

A procalcitonin test is mostly performed in people who have been admitted to the hospital or visit the emergency room for medical care.

No preparations are required for this test.

Procalcitonin test is performed on a blood sample. A laboratory technician will use a sterile syringe to withdraw the required amount of blood from a vein in your arm. You may feel a slight sting as the needle goes in.

After the test, some people tend to feel temporary dizziness or lightheadedness. However, it is nothing to worry about. If you notice a persistent bruise or an infection at the blood withdrawal site, please talk to your doctor.

Normal results:

For infants below the age of 72 hours, a reference value has not been established. For adults and children above 72 hours of age, the reference value is 0.15 ng/mL (nanograms per millilitre) or less. 

Abnormal results:

If the procalcitonin levels are slightly elevated (0.15-2 ng/mL), it may be associated with the following conditions:

  • Mild-to-moderate localised bacterial infection
  • End-stage renal failure that was untreated
  • Non-infectious systemic inflammatory response

Conditions in which procalcitonin levels are elevated above 2 ng/mL include:

  • Bacterial sepsis
  • Severe non-infectious inflammatory conditions (e.g., severe trauma, severe burns, acute multiorgan failure, major abdominal or cardiothoracic surgery)
  • Severe localised bacterial infection (e.g., severe pneumonia, meningitis)
  • Medullary thyroid carcinoma (procalcitonin may exceed 10000 ng/mL)

Children suffering from urinary tract infection may have a procalcitonin level of more than 0.5 ng/mL if there is kidney damage.

In newborns younger than 72 hours, the following procalcitonin levels may indicate a serious bacterial infection:

  • More than 1 ng/mL at birth
  • 100 ng/mL or higher at 24 hours of age
  • 50 ng/mL or higher at 48 hours of age

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. American Association for Clinical Chemistry.[internet]. Washington DC (U.S.A). Do We Need Procalcitonin for Sepsis?
  2. Luís Cabral. The Use of Procalcitonin (PCT) for Diagnosis of Sepsis in Burn Patients: A Meta-Analysis. PLoS One. 2016; 11(12): e0168475. PMID: 28005932
  3. Wacker C. Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis. Lancet Infect Dis. 2013 May;13(5):426-35. PMID: 23375419
  4. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; Sepis
  5. Balci C, Sungurtekin H, Gürses E, Sungurtekin U, Kaptanoğlu, B. Usefulness of procalcitonin for diagnosis of sepsis in the intensive care unit. Crit Care. Published: 30 October 2002
  6. Children's Minnesota [internet]. Children's Hospitals and Clinics of Minnesota. U.S. Procalcitonin
  7. Michael Meisner. Update on Procalcitonin Measurements. Ann Lab Med. 2014 Jul; 34(4): 263–273. PMID: 24982830
  8. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2018. Sepsis
  9. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests
  10. Liang JW et al. Value of Procalcitonin in Neonatal Infection within 24 Hours after Birth: a Retrospective Cohort Study. Clin Lab. 2019 Jul 1;65(7). PMID: 31307162
  11. Aryafar A, Di Marzio A, Guillard O, Pontailler M, Vicca S, Bojan M. Procalcitonin Concentration Measured Within the First Days of Cardiac Surgery Is Predictive of Postoperative Infections in Neonates: A Case-Control Study. Pediatr Cardiol. 2019 Aug;40(6):1289-1295. PMID: 31312866
  12. Meisner M, Dresden-Neustadt SK. UNI-MED. Procalcitonin-Biochemistry and Clinical Analysis. 1st edition. 2010.
  13. Dandona P, Nix D, Wilson MF, Aljada A, Love J, Assicot M. Procalcitonin increase after endotoxin injection in normal subjects. J Clin Endocrinol Metab. 1994 Dec. 79(6):1605-8. PMID: 7989463
  14. National Health Service [internet]. UK; Blood Tests
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