Article

Original Article

Korean J Lab Med 2010; 30(4): 406-413

Published online August 1, 2010 https://doi.org/10.3343/kjlm.2010.30.4.406

Copyright © Korean Society for Laboratory Medicine.

Clinical Significance of Serum Procalcitonin in Patients with Community-acquired Lobar Pneumonia

Jin Yong Lee, M.D.1, Su Jin Hwang, M.D.1, Jae Won Shim, M.D.1, Hye Lim Jung, M.D.1, Moon Soo Park, M.D.1, Hee Yeon Woo, M.D.2, and Jung Yeon Shim, M.D.1

Departments of Pediatrics1 and Laboratory Medicine2, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence to: Jung Yeon Shim, M.D.
Division of Pediatric Allergy & Pulmonology, Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyeong-dong, Jongno-gu, Seoul 110-746, Korea
Tel : +82-2-2001-2484, Fax : +82-2-2001-2199
E-mail : jy7.shim@samsung.com

Received: February 15, 2010; Revised: July 24, 2010; Accepted: July 27, 2010

Abstract

Background: Community-acquired pneumonia (CAP) is a common respiratory disorder in children, which necessitates hospitalization. Bacterial pneumonia, especially lobar pneumonia and parapneumonic effusions, is associated with considerably severe clinical course and extensive alveolar infiltrates. Serum procalcitonin (PCT) level has been used to distinguish bacterial from viral infections, but its usefulness is disputed. The diagnostic accuracy and usefulness of PCT, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count were determined by comparing their values in the patients with CAP with those in healthy controls.
Methods: The serum PCT levels, as well as CRP level, ESR, and WBC counts, were measured in 76 hospitalized patients with CAP (lobar pneumonia, 16; bronchopneumonia, 60) and 18 healthy controls. Serum PCT level was measured using VIDAS® BRAHMS PCT (Biomerieux, France), and ROC curve analysis was performed to evaluate its diagnostic accuracy.
Results: Serum PCT levels were higher in the patients with CAP than in healthy controls, especially in the patients with lobar pneumonia than in those with bronchopneumonia. Serum CRP level was also significantly elevated in the patients with CAP, especially in those with lobar pneumonia. The diagnostic accuracy of serum PCT level for the diagnosis of lobar pneumonia was better than those of serum CRP level and ESR. The serum PCT level was significantly correlated with the CRP level, ESR, and WBC count.
Conclusions: Serum PCT level was a better marker than CRP level or ESR for the diagnosis of lobar pneumonia in children with CAP.

Keywords: Procalcitonin, Child, C-reactive protein, Pneumonia, Erythrocyte sedimentation rate