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Serum procalcitonin as a biomarker for differentiating between infectious and non‐infectious fever after pancreas transplantation
Author(s) -
Shim Ye Eun,
Shin Sung,
Ko Youngmin,
Kim Dong Hyun,
Lim Seong Jun,
Jung Joo Hee,
Kwon Hyunwook,
Kim Young Hoon,
Kim SungHan,
Lee SangOh,
Han Duck Jong
Publication year - 2021
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14224
Subject(s) - procalcitonin , medicine , fever of unknown origin , transplantation , immunology , gastroenterology , bacteremia , sepsis , antibiotics , microbiology and biotechnology , biology
Laboratory biomarkers that can differentiate non‐infectious fever from infectious fever after pancreas transplantation have yet to be discovered. Non‐infectious fever was defined as the presence of fever (>38.3°C) in the absence of a documented clinical diagnosis of infection or a positive culture. Among 184 consecutive recipients, a total of 91 recipients developed fever within 1‐month post‐transplant, of whom 46 had infectious fever and 45 had non‐infectious fever at our center between August 2014 and July 2019. The onset of fever was earlier in the non‐infectious fever group (14.4 ± 3.7 post‐transplant days) compared with the infectious fever group (16.5 ± 5.8 post‐transplant days; p = .033). Multivariate analysis showed that serum procalcitonin at the peak of fever could significantly differentiate infectious fever from non‐infectious fever (OR 53.378, 95% CI: 6.819‐417.802, p < .001). The area under the curve for differentiating between the two groups was 0.853 (95% CI, 0.780‐0.926) for procalcitonin and 0.667 (95% CI, 0.549‐0.785) for CRP. The best cutoff values of serum procalcitonin and CRP were 0.405 ng/ml (sensitivity, 77.1%; specificity, 80.8%) and 7.355 mg/dl (sensitivity, 66.7%; specificity, 67.3%), respectively. Serum procalcitonin may be useful for differentiating non‐infectious fever from infectious fever after pancreas transplantation.