Original articleSerum levels of C-reactive protein and procalcitonin in critically ill patients with cirrhosis of the liver
Section snippets
Methods
We prospectively collected data from all critically ill patients admitted to a 31-bed department of intensive care of a tertiary-care hospital during 3 distinct convenience periods (June-September 2000, June and July 2003, May-July 2004). Demographic, clinical, laboratory, and microbiologic data were collected throughout each patient’s stay. The institution’s ethics committee approved the study, but, because all the parameters assessed were routinely obtained in this department at the time of
Results
We enrolled 864 patients, 79 (9%) of whom had hepatic cirrhosis. Characteristics of the patients are summarized in Table I. Patients with cirrhosis were more likely to have a medical than a surgical admission diagnosis (67% vs 47%, P = .03) and had a higher mortality rate (44% vs 17%, P = .01) than that of patients without cirrhosis. They also had greater disease severity, as assessed on the basis of the APACHE II score, and a greater degree of organ dysfunction, as defined by the SOFA score,
Discussion
Our findings indicate no significant differences in the serum levels of CRP and PCT between patients with and without cirrhosis. Two mechanisms, alone or in combination, may explain these findings: first, that CRP and PCT are, in fact, produced mainly by the liver, and their production is maintained by the hepatocytes in cirrhosis. Three studies demonstrating increased concentrations of CRP in noninfected patients with cirrhosis, regardless of the nature of the cirrhosis (inflammatory or
References (26)
- et al.
C-reactive protein is useful in distinguishing Gram stain–negative bacterial meningitis from viral meningitis in children
J Pediatr
(1999) - et al.
Human neurons generate C-reactive protein and amyloid Pupregulation in Alzheimer’s disease
Brain Res
(2000) - et al.
Flow cytometric analysis of procalcitonin expression in human monocytes and granulocytes
Immunol Lett
(2002) - et al.
CDC definitions for nosocomial infections, 1988
Am J Infect Control
(1988) - et al.
Serum levels of cytokines in chronic liver diseases
Gastroenterology
(1992) - et al.
Cirrhosis as a risk factor for sepsis and deathanalysis of the National Hospital Discharge Survey
Chest
(2003) - et al.
C reactive protein in patients with chronic renal diseases
Ren Fail
(2001) - et al.
Infection probability score (IPS)a simple method to help assess the probability of infection in critically patients
Crit Care Med
(2003) - et al.
The potential role of procalcitonin and interleukin 8 in the prediction of infected necrosis in acute pancreatitis
Gut
(1997) - et al.
Usefulness of procalcitonin for diagnosing complicating sepsis in patients with cardiogenic shock
Intensive Care Med
(2003)
Procalcitonin, a donor-specific predictor of early graft failure–related mortality after heart transplantation
Circulation
Inflammatory cytokines stimulated C-reactive protein production by human coronary artery smooth muscle cells
Circulation
The kidney as a second site of human C-reactive protein formation in vivo
Eur J Immunol
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2020, Transplantation ProceedingsCitation Excerpt :In fact, conflicting results exist regarding threshold values and diagnostic accuracy of CRP and PCT in patients with cirrhosis. Bota et al [21], in the evaluation on 79 cirrhotic patients, showed that the serum CRP concentration (admission 11.2 ± 4.6 vs 13.0 ± 5.8, maximum 13.9 ± 6.4 vs 18.8 ± 7.3 mg/dL) and PCT (admission 1.3 ± 0.9 vs 2.0 ± 1.4, maximum 3.3 ± 1.8 vs 3.4 ± 2.1 ng/mL) were slightly lower in infected patients with cirrhosis than in infected patients without cirrhosis, but the differences were not statistically significant. Recently, a new biomarker was introduced.