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Additional benefit of procalcitonin to C‐reactive protein to assess disease activity and severity in Crohn’s disease
Author(s) -
Oussalah A.,
Laurent V.,
Bruot O.,
Guéant J.L.,
Régent D.,
Bigard M.A.,
PeyrinBiroulet L.
Publication year - 2010
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2010.04459.x
Subject(s) - procalcitonin , medicine , crohn's disease , c reactive protein , disease , crohn disease , severity of illness , gastroenterology , intensive care medicine , immunology , inflammation , sepsis
Aliment Pharmacol Ther 2010; 32: 1135–1144 Summary Background Serum procalcitonin level may reflect non‐infectious inflammation. Aim To assess the correlation of serum procalcitonin level with clinical, biological, endoscopic and radiological markers of disease activity in inflammatory bowel diseases (IBD), and to evaluate the additional diagnostic benefit of measuring serum procalcitonin level to that of C‐reactive protein (CRP) for disease activity appraisal. Methods We performed a prospective observational study. Spearman’s rank correlation and receiver operating characteristic analysis were used to evaluate correlation and diagnostic accuracy respectively. Results In Crohn’s disease (CD) ( n = 30), serum procalcitonin level was strongly correlated with clinical, biological, endoscopic and radiological disease activity markers. In CD, the serum procalcitonin level >0.14 μg/L demonstrated a high accuracy for detecting severe disease (Sensitivity = 100%; Specificity = 96%; AUROC = 0.963; P = 0.0001). The diagnostic accuracy of the ‘serum procalcitonin level‐CRP strategy’ (CRP >5 mg/L and serum procalcitonin level >0.05 μg/L) was significantly superior to that of CRP alone for diagnosing severe CD (AUROC = 0.783 vs. 0.674; P = 0.01). In ulcerative colitis (UC) ( n = 27), serum procalcitonin level was correlated with CRP and with endoscopic and radiological disease activity markers. Conclusions In CD, the serum procalcitonin level was correlated with all disease activity markers and a cut‐off of 0.14 μg/L could distinguish severe forms of the disease. The ‘serum procalcitonin level‐CRP strategy’ was superior to CRP alone for diagnosing active or severe CD.