Use of procalcitonin in the diagnosis of tuberculosis in infants and preschool children
Normal procalcitonin (PCT) levels have been reported in adult pulmonary tuberculosis (TB) but have not been previously investigated in children. We aimed to assess PCT levels at diagnosis of TB in young children in a low-burden setting. In a cross-sectional observational study in a referral pediatric center in Barcelona (Spain), we assessed the value of PCT and other inflammatory markers (leucocyte counts, C-reactive protein, and erythrocyte sedimentation rate) in the diagnosis of TB in pre-school children (< 6 years at diagnosis, n = 45), as compared with two control groups (pneumococcal pneumonia, n = 25; and healthy controls, n = 49). Normal PCT levels were observed at diagnosis of TB in most cases, while C-reactive protein values and leucocyte counts were slightly elevated when compared to healthy controls. All three inflammatory biomarkers were significantly higher in children with pneumococcal pneumonia.
What is Known:
• Diagnosis of pediatric tuberculosis on clinical evidence is difficult, particularly in infants and small children.
• Studies in adults with tuberculosis have mostly reported normal procalcitonin levels at diagnosis.
What is New:
• In pre-scholars with tuberculosis, erythrocyte sedimentation rate and white blood cell counts were higher than in healthy controls, but procalcitonin was not.
• Procalcitonin may be useful in the differential diagnosis of intrathoracic tuberculosis and pneumococcal pneumonia.
KeywordsC-reactive protein Erythrocyte sedimentation rate Pneumonia Procalcitonin Tuberculosis
Erythrocyte sedimentation rate
QuantiFERON-TB Gold In-Tube
Tuberculin skin test
White blood cell
We are indebted to the “Biobanc de l’Hospital Infantil Sant Joan de Déu per a la Investigació,” a member of the ISCIII National Network of Biobanks, for sample and data procurement.
EVA, EP, CF, and ANJ designed the study. DH, AV, and PB developed the methodology. EVA, EP, DH, AFL, and CF collected the data. EVA and ANJ performed the analysis and wrote the first draft of the manuscript. All authors saw, approved, and take full responsibility for the final version of the manuscript.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Consent for publication
Informed consent was obtained from all individual participants included in the study.
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