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9 Oct,
11 tweets, 7 min read
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โก๏ธProcalcitonin as the name suggests is a precursor of the hormone calcitonin
โก๏ธCoded by the CALC 1 gene on Chr 11,its a 116AA peptide
โก๏ธPrePCT >> PCT >> Calcitonin
โก๏ธBact inf=โฌ๏ธIL6โฌ๏ธTNFaโฌ๏ธIL1b=โฌ๏ธProductn of PCT
โก๏ธCoded by the CALC 1 gene on Chr 11,its a 116AA peptide
โก๏ธPrePCT >> PCT >> Calcitonin
โก๏ธBact inf=โฌ๏ธIL6โฌ๏ธTNFaโฌ๏ธIL1b=โฌ๏ธProductn of PCT
โก๏ธNormal PCT in health <0.1ng/ml
โก๏ธIn patients with bacterial infections PCT โฌ๏ธ corelates with severity of infection
โก๏ธPCT starts toโฌ๏ธ3-4hrs following an infection,
peaks at ~12 hrs post infection.
โก๏ธIn patients with bacterial infections PCT โฌ๏ธ corelates with severity of infection
โก๏ธPCT starts toโฌ๏ธ3-4hrs following an infection,
peaks at ~12 hrs post infection.
โก๏ธThe image below beautifully summarizes the kinetic profile of biomarkers in bacterial infections
โก๏ธAs seen CRP rises and peaks later and stays elevated for a longer time even after resolution of infection.
โก๏ธAs seen CRP rises and peaks later and stays elevated for a longer time even after resolution of infection.
โก๏ธBut there are other reasons for an โฌ๏ธPCT like major surgery, burns, severe trauma etc.
Cardiogenic shock also l/t โฌ๏ธPCT
โก๏ธThat's where serial monitoring becomes important.
The levels wont stay elevated in these conditions.
โก๏ธMed Ca thyroid and SCLC l/t โฌ๏ธPCT(dysreg productn)
Cardiogenic shock also l/t โฌ๏ธPCT
โก๏ธThat's where serial monitoring becomes important.
The levels wont stay elevated in these conditions.
โก๏ธMed Ca thyroid and SCLC l/t โฌ๏ธPCT(dysreg productn)
โก๏ธSimilarly a Normal PCT doesn't r/o bact infection. Localized infections like empyema, osteomyelitis can have normal PCT.
โก๏ธPCT is quantified by immunoassay technique. The 1st commercial kit was BRAHMS PCT LIA.
โก๏ธPCT Kryptor an automated assay was FDA approved in 2008
โก๏ธPCT is quantified by immunoassay technique. The 1st commercial kit was BRAHMS PCT LIA.
โก๏ธPCT Kryptor an automated assay was FDA approved in 2008
โก๏ธSemiquantitative strip tests use immunochromatography and serve as point of care tests for PCT.
โก๏ธPCT guided antibiotic therapy was evaluated in the PRORATA trial and it was effective inโฌ๏ธantibiotic exposure.
โก๏ธHowever, โฌ๏ธPCT is not a good marker for intensifying antibiotics (PASS study data)
โก๏ธHowever, โฌ๏ธPCT is not a good marker for intensifying antibiotics (PASS study data)
โก๏ธA combination of CRP and PCT may prove helpful in distinguishing bacterial vs IFI in patients with febrile neutropenia.
โฌ๏ธPCT and โฌ๏ธCRP should lead to a high suspicion of IFI in patients with neutropenia.
โฌ๏ธPCT and โฌ๏ธCRP should lead to a high suspicion of IFI in patients with neutropenia.
References :
dx.doi.org/10.1097/HS9.00โฆ
Meisner M. Procalcitonin -Biochemistry and Clinical
Diagnosis. ISBN
PRORATA trial ; Lancet 2010
dx.doi.org/10.1097/HS9.00โฆ
Meisner M. Procalcitonin -Biochemistry and Clinical
Diagnosis. ISBN
PRORATA trial ; Lancet 2010
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