Ann Lab Med.  2013 Nov;33(6):449-454. 10.3343/alm.2013.33.6.449.

Procalcitonin and C-Reactive Protein in the Diagnosis and Prediction of Spontaneous Bacterial Peritonitis Associated With Chronic Severe Hepatitis B

• Yuan LY
• Ke ZQ
• Wang M
• Li Y

• KMID: 1711319
• DOI: http://doi.org/10.3343/alm.2013.33.6.449

Abstract

BACKGROUND
Procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBCs) are inflammatory markers used to diagnose severe bacterial infections. We evaluated the diagnostic role of these markers and compared their accuracy for spontaneous bacterial peritonitis (SBP) associated with chronic severe hepatitis B (CSHB).
METHODS
PCT and CRP concentrations, WBC count, and other hematological parameters were measured in serum from 84 well-characterized patients with CSHB, of whom 42 had SBP. Receiver operating characteristics (ROC) curve analysis was performed to assess the diagnostic accuracy.
RESULTS
PCT and CRP concentrations were significantly higher in the CSHB patients with SBP (n=42) than CSHB patients without SBP (n=42). PCT and CRP concentrations were more accurate than WBC count for the diagnosis of CSHB-associated SBP. The optimal cutoff value of PCT was 0.48 ng/mL. The PCT concentration was significantly correlated with the CRP concentration and WBC count.
CONCLUSIONS
Serum PCT and CRP seems to be better markers than WBC for the diagnosis of CSHB patients with SBP.

Keyword

Chronic severe hepatitis B; Procalcitonin; C-reactive protein; White blood cell

MeSH Terms

Age Factors
Area Under Curve
Bacterial Infections/complications/*diagnosis
Biological Markers/blood
C-Reactive Protein/*analysis
Calcitonin/*blood
Female
Hepatitis B, Chronic/*complications
Humans
Leukocyte Count
Leukocytes/cytology
Male
Middle Aged
Peritonitis/complications/*diagnosis
Protein Precursors/*blood
ROC Curve
Sex Factors
Temperature
Biological Markers
C-Reactive Protein
Calcitonin
Protein Precursors

Figure

• 

  Fig. 1 (A) Distribution of the serum concentrations of procalcitonin (PCT) and (B) C-reactive protein (CRP) and (C) white blood cell (WBC) count in chronic severe hepatitis B (CSHB) patients with or without spontaneous bacterial peritonitis (SBP).

• 

  Fig. 2 ROC curve showing the diagnostic values of PCT, CRP, and WBC for the differentiation between CSHB patients with and without SBP. Areas under the curve were calculated for PCT (AUC, 0.89; 95% CI, 0.81-0.96; sensitivity 95% and specificity 79% at the optimal cutoff of 0.48 mg/L), CRP (AUC, 0.86; 95% CI, 0.78-0.94; 64%/95% at 16.15 mg/L), and WBC (AUC, 0.68; 95% CI, 0.57-0.78; 52%/86% at 8.23×109 cells/L).Abbreviations: AUC, area under the curve; CRP, C-reactive protein; CSHB, chronic severe hepatitis B; PCT, procalcitonin; SBP, spontaneous bacterial peritonitis; WBC, white blood cell.

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