The potential role of procalcitonin and interleukin 8 in the prediction of infected necrosis in acute pancreatitis

• DOI: 10.1136/gut.41.6.832
• Publication Date: 2010-06-30T16:46:12Z
• Authors: B Rau; G Steinbach; F Gansauge; J M Mayer; A Grünert; H G Beger
• Keywords: Procalcitonin

Background— Infection of pancreatic necrosis has a major impact on clinical course, management, and outcome in acute pancreatitis. Currently, guided fine needle aspiration is the only means for an early accurate diagnosis infected necrosis. Procalcitonin (PCT), 116 amino acid propeptide calcitonin, interleukin 8 (IL-8), strong neutrophil activating cytokine, are markers severe inflammation sepsis. Aims— To analyse value PCT IL-8 as biochemical parameters predicting Patients methods— Fifty patients with pancreatitis entered this prospective study were stratified into three groups according to morphological bacteriological findings: 18 oedematous (group I), 14 sterile II), who developed median 13.5 days after onset symptoms III). After admission serum samples drawn daily two weeks. Concentrations measured by chemoluminescent immunoassays (upper reference range 0.5 ng/ml 70 pg/ml IL-8). The routine parameter C-reactive protein was determined laser nephelometry 10 mg/l). Results— Median concentrations significantly higher than those during observation period, whereas there no difference protein. In overall all low. By receiver operating characteristics best cut off levels or persisting sepsis 1.8 112 IL-8. If these reached at least days, sensitivity, specificity, accuracy prediction 94%, 91%, 92% 72%, 75%, 74% IL-8, respectively. surgical treatment values continued be (n=11) compared having uneventful postoperative course (n=7). For preoperative differentiation between performed 24 necrotising diagnostic 84% 87% PCT, 68% There correlation aetiology extent Conclusion— found high associated systemic complications shows closest presence Monitoring potential new marker non-invasive well selection septic debridement.