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J Infect. 2014 May;68(5):440-7. doi: 10.1016/j.jinf.2013.12.012. Epub 2014 Jan 3.

High serum levels of procalcitonin and soluble TREM-1 correlated with poor prognosis in pulmonary tuberculosis.

Author information

  • 1Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; Department of Traumatology, National Taiwan University Hospital, Taipei 100, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University, Taipei 100, Taiwan.
  • 2Department of Laboratory Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
  • 3Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
  • 4School of Medicine, College of Medicine, Fu-Jen Catholic University, Taipei 100, Taiwan.
  • 5Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan. Electronic address: jywang@ntu.edu.tw.

Abstract

OBJECTIVES:

Comparisons of procalcitonin (PCT), C-reactive protein (CRP), and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) would expand our knowledge of which biomarker is the best predictor for outcomes of patients with pulmonary tuberculosis (PTB).

METHODS:

We prospectively enrolled 243 PTB patients, in whom PCT, CRP, and sTREM-1 measurement were performed to evaluate their prognostic value for 6-month mortality.

RESULTS:

Serum PCT, CRP, and sTREM-1 levels on diagnosis of PTB were significantly higher in nonsurvivors (2.22 ± 6.22 vs. 0.13 ± 0.31 ng/mL, P = 0.043; 42.1 ± 59.4 vs. 12.5 ± 29.1 mg/L, P = 0.004; 332 ± 362 vs. 128 ± 98 pg/mL, P = 0.001, respectively) as compared with 6-month survivors. In multivariate Cox regression analysis, PCT ≧ 0.5 ng/mL (hazard ratio 4.13, 95% CI, 1.99-8.58) and sTREM-1 ≧ 129 pg/mL (hazard ratio 3.39, 95% CI, 1.52-7.58) remained independent mortality predictors. Serum PCT and sTREM-1 levels above the cutoffs were also associated with the presence of disseminated tuberculosis.

CONCLUSIONS:

Among PTB patients, higher PCT, CRP, and sTREM-1 levels are observed in nonsurvivors than in 6-month survivors. Serum levels of PCT and sTREM-1 over the cutoffs are independently associated with a poor outcome. In addition, higher PCT and sTREM-1 levels would raise the clinical suspicion of disseminated tuberculosis.

Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

KEYWORDS:

Biomarker; C-reactive protein; Procalcitonin; Prognosis; Triggering receptor expressed on myeloid cells-1; Tuberculosis

PMID:
24393650
[PubMed - in process]
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