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Procalcitonin as a marker of sepsis in alcoholic hepatitis

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Abstract

Background

Early diagnosis of sepsis in alcoholic hepatitis is important for selecting the appropriate therapy. The role of procalcitonin (PCT) to diagnose sepsis in patients with alcoholic hepatitis and systemic inflammatory response syndrome (SIRS) is not yet clear.

Methods

All patients admitted with alcoholic hepatitis and SIRS underwent measurement of serum PCT and C reactive protein (CRP) levels within 24 h of admission. Patients were classified into two groups: group 1, alcoholic hepatitis with SIRS alone; group 2, alcoholic hepatitis with SIRS and sepsis. The ability of PCT to predict sepsis was evaluated using receiver-operating characteristic (ROC) analyses to compare the two groups.

Results

The study included 11 patients in group 1 and 29 in group 2. All were male (median age 42 years; range, 24–65 years). Age, dose and duration of alcohol intake, biochemical parameters and median MELD score were not significantly different between the two groups. PCT and CRP were significantly higher among group 2 than group 1 patients (p < 0.05). ROC analysis showed an AUC of 0.81 (95 % CI 0.66–0.96) and 0.83 (95 % CI 0.68–0.93) for PCT and CRP, respectively, in distinguishing sepsis from SIRS without sepsis. A cutoff level of 0.57 mcg/l for PCT (sensitivity 79 %, specificity 82 %) for diagnosing sepsis in patients with alcoholic hepatitis and SIRS was comparable to a serum CRP cutoff level of 2.3 mg/dl (sensitivity 82.0 %, specificity 75 %).

Conclusion

Serum PCT can be a useful marker for diagnosing sepsis in patients with alcoholic hepatitis and SIRS and compares favorably with serum CRP levels.

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Compliance with ethical requirements and Conflict of interest

All procedures followed were in accordance with the ethics standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for inclusion in the study. Kundan Kumar, Samir Mohindra, Mithun Raj and Gourdas Choudhuri declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), MRA-A23, SGPGI Campus, Rae Bareli Road, Lucknow, 226014, Uttar Pradesh, India

    Kundan Kumar

  2. Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raibareily Road, Lucknow, 226014, India

    Kundan Kumar, Samir Mohindra, Mithun Raj & Gourdas Choudhuri

Authors
  1. Kundan Kumar
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  2. Samir Mohindra
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  4. Gourdas Choudhuri
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Correspondence to Kundan Kumar.

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Kumar, K., Mohindra, S., Raj, M. et al. Procalcitonin as a marker of sepsis in alcoholic hepatitis. Hepatol Int 8, 436–442 (2014). https://doi.org/10.1007/s12072-014-9540-x

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  • DOI: https://doi.org/10.1007/s12072-014-9540-x

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