Procalcitonin as an Indicator of Infection in
Patients with Liver Cirrhosis
Husová L.1, Husa P.2, Šenkyřík M.1, Lata J.1
1Interní gastroenterologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Petr Dítě, DrSc. 2Klinika nemocí infekčních Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta doc. MUDr. Pavel Chalupa, CSc. |
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Summary:
Incidence of bacterial infections in hospitalised patients with liver disease is high. Due to a liver
dysfunction immune reactivity is significantly impaired and bacterial infections are more frequent.
Also incidence of nosocomial infections is higher in patients with liver disease compared to
patients hospitalised for other conditions. To make a differential diagnosis of infectious and noninfectious
aetiology of an inflammation is very difficult. Characteristic laboratory tests for bacterial
infection include test of a number of leucocytes in peripheral blood, differential count of
leucocytes, erythrocyte sedimentation, procalcitonin, C-reactive protein, tumor necrosis factor
alpha, interleukin-1, interleukin-6, interleukin-8, and complement fragment C3a. Clinically the
most significant are C-reactive protein test and procalcitonin test. Procalcitonin is a protein,
a calcitonin precursor, which is in healthy individuals produced by cells of thyroid gland. A halflife
of procalcitonin in serum is 20 – 24 hours which makes it suitable for daily monitoring and
enables to control a course of treatment and to distinguish bacterial infection from other types of
inflammations. Procalcitonin levels rise in bacterial, parasite, and yeast infections. Elevated procalcitonin
levels appear only in inflammations of an infectious etiology with systemic signs. In
patients with liver cirrhosis bacterial infections are more frequent. They usually include spontaneous
bacterial peritonitis, infection of the respiratory system, urinary infections, and bacteremia.
A timely proof of a bacterial infection and an appropriate and effective antibiotic therapy
lead to an improvement of the general state of a patient and to his/her better prognosis. Procalcitonin
determination is appropriate for diagnosing infections and control of treatment.
Key words:
Procalcitonin - Bacterial infection - Liver cirrhosis
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