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Test Code PROCALCITONIN PROCALCITONIN

Department

Chemistry

Specimen Type

Plasma or Serum

Method

Chemiluminescent Immunoassay

Container

Lithium heparin (green-top) or No additive with gel (gold top)

Standard Volume

7ml

Minimum Volume

2ml

Pediatric Volume

2 Microtainers (Gold or Green)

Ship Temperature

Room Temperature

Stability Refrigerated

48 hours

Stability Room Temp

16 hours

Stability Frozen

75 days

CPT Code

84145

Days Test Set Up

Monday through Sunday

Group Components

PROCALCITONIN

Clinical Information

Procalcitonin is the prohormone of the hormone calcitonin, but procalcitonin and calcitonin are distinct proteins. Calcitonin is produced exclusively by C-cells of the thyroid gland in response to hormonal stimulis, whereas procalcitonin can be produced by several cell types and many organs in response to pro-inflammatory stimuli, in particular by bacerial products.
In healthy people, plasma procalcitonin levels are found to be below 0.1 ng/ml. Procalcitonin levels rise rapidly (within 6 – 12 hours) after a bacterial infectious insult with systemic consequences. Early after multiple traumas, major surgery, severe burns, or in neonates procalcitonin levels can be elevated independently of an infectious process, but the return to baseline occurs rapidly. Viral infections, bacterial colonization, localized infections, allergice disorders, autoimmune diseases, and transplant rejection do not usually induce a significant procalcitonin response.

Test Use

The procalcitonin test is intended for use in conjunction with other laboratory findings and clinical assessments to aid i the risk assessment of critically ill patients on their first day of admission for progression to severe sepsis and septic shock.

Cautions

Increased levels may not always be related to sytemic infection. These conditions include, but are not limited to: the first days of major trauma, treatment with OKT3 antibodies, interleukins, and TNF-alpha and other drugs stimulating the release of pro-inflammatory cytokines, patients with medullary C-cell carcinoma, small cell lung carcinoma, or bronchial carcinoid, and patients with prolonged or severe cardiogenic shock, prolonged sever organ perfusion anomalies, Child-Pugh Class C liver disease, and peritoneal dialysis treatment.

Interpretation

Procalcitonin levels less than 0.5 ng/ml on the first day of ICU admission present a low risk for progression to severe sepsis and/or shock. Levels this low do not preclude an infection, because localized infections (without systemic signs) may also be associated with low levels. If the PCT measurement is done very early after the systemic infections has started, these values may still be low.
Procalcitonin levels greater than 2 ng.ml on the first day of ICU admission represent a high risk for progression to severe sepsis and/or septic shock.
As various non-infectious conditions are known to induce PCT as well, levels between 0.5 and 2 ng/ml should be reviewed carefully to take into account the specific background and condition of the individual patient.