Procalcitonin Identifies Cell Injury, Not Bacterial Infection, in Acute Liver Failure
| Autor: | Steven Han, Daniel Ganger, Natalie Murray, William M. Lee, Alastair D. Smith, A. Obaid S. Shaikh, Nahid Attar, Jeffrey S. Crippin, Edwyn M Harrison, Anne M. Larson, Jody Rule, Michael L. Schilsky, Brendan M. McGuire, Raymond T. Chung, R. Todd Stravitz, J. Eileen Hay, Tarek Hassanein, William J. Korzun, Santiago Munoz, Timothy M. McCashland, Robert S. Brown, Corron Sanders, Oren K. Fix, Atif Zaman, Linda S. Hynan, Andres T. Blei, Adrian Reuben, Rajender Reddy, Iris Liou, Timothy J. Davern, Robert J. Fontana, Lorenzo Rossaro, Raj Satyanarayana |
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| Rok vydání: | 2015 |
| Předmět: |
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lcsh:Medicine Chronic liver disease Severity of Illness Index Gastroenterology Procalcitonin Prospective Studies lcsh:Science Aged 80 and over Liver injury education.field_of_study Multidisciplinary digestive oral and skin physiology Bacterial Infections Middle Aged Shock Septic Systemic Inflammatory Response Syndrome Biomarker (medicine) Female hormones hormone substitutes and hormone antagonists Research Article Adult Calcitonin congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Adolescent Calcitonin Gene-Related Peptide Population Sepsis Young Adult Internal medicine parasitic diseases medicine Humans Protein Precursors education Aged Retrospective Studies Inflammation Septic shock business.industry lcsh:R Liver Failure Acute bacterial infections and mycoses medicine.disease Systemic inflammatory response syndrome Immunology lcsh:Q business Biomarkers |
| Zdroj: | PLoS ONE, Vol 10, Iss 9, p e0138566 (2015) PLoS ONE |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0138566 |
| Popis: | Background Because acute liver failure (ALF) patients share many clinical features with severe sepsis and septic shock, identifying bacterial infection clinically in ALF patients is challenging. Procalcitonin (PCT) has proven to be a useful marker in detecting bacterial infection. We sought to determine whether PCT discriminated between presence and absence of infection in patients with ALF. Method Retrospective analysis of data and samples of 115 ALF patients from the United States Acute Liver Failure Study Group randomly selected from 1863 patients were classified for disease severity and ALF etiology. Twenty uninfected chronic liver disease (CLD) subjects served as controls. Results Procalcitonin concentrations in most samples were elevated, with median values for all ALF groups near or above a 2.0 ng/mL cut-off that generally indicates severe sepsis. While PCT concentrations increased somewhat with apparent liver injury severity, there were no differences in PCT levels between the pre-defined severity groups–non-SIRS and SIRS groups with no documented infections and Severe Sepsis and Septic Shock groups with documented infections, (p = 0.169). PCT values from CLD patients differed from all ALF groups (median CLD PCT value 0.104 ng/mL, (p ≤0.001)). Subjects with acetaminophen (APAP) toxicity, many without evidence of infection, demonstrated median PCT >2.0 ng/mL, regardless of SIRS features, while some culture positive subjects had PCT values |
| Databáze: | OpenAIRE |
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