Can Procalcitonin Help The Diagnosis of Osteomyelitis in Adults?: A Prospective Study

Abstract

SUMMARY

Aim: The aim of this study was to evaluate the sensitivity, specificity and predictive values of procalcitonin in adults patients with osteomyelitis.

Material and Methods: A total of 30 consecutive patients with osteomyelitis and 30 healthy controls were enrolled in this study. The white blood cell count, erythrocyte sedimentation rate, C-reactive protein and procalcitonin (PCT) levels of the patients and controls were detected. Procalcitonin was measured by an Enzyme-Linked Immunosorbent Assay (Ray Bio^® Human Procalcitonin ELISA Kit, Norcross GA, USA). Values of PCT levels >0,5 ng/ml were considered as high than normal.

Results: Among 30 patients included in the study 4 of them were subacute osteomyelitis while 26 of them were chronic osteomyelitis. The ratio of the female to male both in patients and the control group was 10/20. The mean age of the patients was 31,16 ±15,32 years, while in control group 32,22±14.32 years. 26 (86,7%) of the patients had clinical signs and symptoms of osteomyelitis. White blood cell count detected high in 5 (16.6%) of them, erythrocyte sedimentation rate was high in 20 (66.6%) of them and  C-reactive protein was positive in 15 (50%) patients, but PCT levels found to be higher in all 30 (100%) patients (PCT>0.5 ng/mL). In our study, the PCT test, with a 0.5 ng/mL cut-off value, had a sensitivity of 100%, a specificity of 56% and a positive predictive value of 100%. The PCT test, with a 0.57 ng/mL cut-off value, had a sensitivity of 87%, a specificity of 86% and a positive predictive value of 87%.  This cut-off value (0.57 ng/mL) is quite suitable in osteomyelitis patients.

Conclusion: The sensitivity, specificity, and positive predictive values of PCT test are more discriminative than the other acute phase reactants in the patients with osteomyelitis. Therefore, the PCT test can be used as a useful marker in the diagnosis of osteomyelitis.

 

Keywords

• Procalcitonin,osteomyelitis

PROKALSİTONİN YETİŞKİNLERDE OSTEOMYELİT TANISINA YARDIMCI OLABİLİR Mİ?: PROSPEKTİF BİR ÇALIŞMA

Abstract

ÖZET

AMAÇ: Bu çalışmanın amacı osteomyelit tanısı alan erişkin hastalarda prokalsitoninin duyarlılık, özgüllük ve prediktif değerini ölçmektir.

MATERYAL VE METOD: Çalışmaya osteomiyelitli 30 hasta ve 30 sağlıklı kontrol grubu alındı. Her iki grubun lökosit sayısı, eritrosit sedimantasyon hızı, C-reaktif protein ve prokalsitonin (PCT) düzeyleri saptandı. Prokalsitonin, Enzyme-Linked Immunosorbent Assay (Ray Bio^® Human Procalcitonin LISA Kit, Norcross GA, USA) yöntemi ile ölçüldü. PCT’nin 0,5 ng/ml'nin üzerinde olan değeri, normalden yüksek olarak kabul edildi.

BULGULAR: Çalışmaya dahil edilen 30 hastanın 4'ü subakut osteomyelit iken; 26'sı kronik osteomyelitti. Hastaların ve kontrol grubundaki toplam kadınların erkeklere oranı 10/20'ydi. Hastaların yaş ortalaması 31,16 ± 15,32 iken, kontrol grubunda ise 32,22 ± 14,32 idi. Hastaların 26'sında (% 86,7) klinik bulgular ve osteomyelit semptomları vardı. 5 (% 16.6) hastada lökosit sayısı yüksek, 20 (% 66.6) hastada eritrosit sedimantasyon hızı yüksek, 15 (% 50) hastada C-reaktif protein pozitif iken 30 (% 100) hastanın tümünde PCT düzeyleri (PCT> 0.5 ng / mL) yüksek bulundu. Çalışmamızda, PCT testinin cut-off değeri 0.5 ng/mL olarak değerlendirildiğinde, duyarlılığı % 100, özgüllüğü % 56 ve pozitif prediktif değeri ise % 100 idi. PCT’nin cut-off değeri 0.57 ng/mL değerlendirildiğinde, duyarlılığı % 87, özgüllüğü % 86 ve pozitif prediktif değeri ise % 87 idi. Bu cut-off değeri (0.57 ng/mL), osteomyelit hastaları için daha uygun görüldü.

SONUÇ: Osteomyelitli hastalarda, PCT testinin duyarlılığı, özgüllüğü ve pozitif prediktif değeri diğer akut faz reaktanlarına göre daha iyi ayırıcı tanıya götürebilmektedir. Bu nedenle PCT testi, osteomyelitin teşhisinde yararlı bir belirteç olarak kullanılabilir.

 

 

Keywords

• prokalsitonin,osteomyelit

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