procalcitonin (LH Indholdsside)

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    <Content>
      <HtmlField Name="PageContent"><![CDATA[<h2>Resum&eacute;</h2>
<ul>
    <li>Procalcitonin-m&aring;ling&nbsp;kan&nbsp;anvendes&nbsp;til at styre/afkorte antibiotika-behandling&nbsp;ved sv&aelig;re infektioner og differentialdiagnostisk ved bakterielle infektioner ved kritisk syge patienter</li>
    <li>Brugen af analysen&nbsp;er dog ikke helt afklaret, og evidensen er forsat ikke st&aelig;rk. Samlet set tyder det dog p&aring;, at anvendelse af procalcitonin kan afkorte behandlings- og indl&aelig;ggelsestid p&aring; intensivafdelinger<a href="EditorPage.aspx?da=core&amp;id=%7BEAC7FE94-7A30-4AC3-8182-D18840EBF999%7D&amp;ed=FIELD1148608300&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H1148608364&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Prkno A, Wacker C, Brunkhorst FM, Schlattmann P, Procalcitonin-guided therapy in intensive care unit patients with severe sepsis and septic shock--a systematic review and meta-analysis.. Crit Care 2013;17: R291" data-value-piped="Prkno A, Wacker C, Brunkhorst FM, Schlattmann P|Procalcitonin-guided therapy in intensive care unit patients with severe sepsis and septic shock--a systematic review and meta-analysis.|Crit Care|2013|17|R291|24330744" data-url="reference-link" data-pubmedid="24330744" title="Prkno A, Wacker C, Brunkhorst FM, Schlattmann P, Procalcitonin-guided therapy in intensive care unit patients with severe sepsis and septic shock--a systematic review and meta-analysis.. Crit Care 2013;17: R291">1</a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Tujula B, Hämäläinen S, Kokki H, Pulkki K, Kokki M, Review of clinical practice guidelines on the use of procalcitonin in infections. Infect Dis (Lond) 2020;52: 227-234" data-value-piped="Tujula B, Hämäläinen S, Kokki H, Pulkki K, Kokki M|Review of clinical practice guidelines on the use of procalcitonin in infections.|Infect Dis (Lond)|2020|52|227-234|31858869" data-url="reference-link" data-pubmedid="31858869" title="Tujula B, Hämäläinen S, Kokki H, Pulkki K, Kokki M, Review of clinical practice guidelines on the use of procalcitonin in infections. Infect Dis (Lond) 2020;52: 227-234">2</a></li>
</ul>
<h2>Definition</h2>
<ul>
    <li>Koncentration i plasma af procalcitonin, m&aring;lt i mikrogram per liter (&micro;g/L)</li>
</ul>
<h2>Synonymer</h2>
<ul>
    <li>PCT; Prokalcitonin</li>
</ul>
<h2>Indikationer<a href="EditorPage.aspx?da=core&amp;id=%7BEAC7FE94-7A30-4AC3-8182-D18840EBF999%7D&amp;ed=FIELD17668609993&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H17668610203&amp;us=sitecore%5Canvi&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Taylor R, Jones A, Kelly S, Simpson M, Mabey J, A Review of the Value of Procalcitonin as a Marker of Infection.. Cureus 2017;9: e1148" data-value-piped="Taylor R, Jones A, Kelly S, Simpson M, Mabey J|A Review of the Value of Procalcitonin as a Marker of Infection.|Cureus|2017|9|e1148|28497010" data-url="reference-link" data-pubmedid="28497010" title="Taylor R, Jones A, Kelly S, Simpson M, Mabey J, A Review of the Value of Procalcitonin as a Marker of Infection.. Cureus 2017;9: e1148">3</a><sup>,</sup><a href="EditorPage.aspx?da=core&amp;id=%7BEAC7FE94-7A30-4AC3-8182-D18840EBF999%7D&amp;ed=FIELD17668609993&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H17668610203&amp;us=sitecore%5Canvi&amp;mo&amp;pe=0&amp;fbd=1" data-type="book-reference" data-value="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. . Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010" data-value-piped="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. |Lyngbyes laboratoriemedicin. 2. udg.|København|Nyt Nordisk Forlag Arnold Busck A/S|2010" data-url="reference-link" title="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. . Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010">4</a><sup>,</sup><a href="EditorPage.aspx?da=core&amp;id=%7BEAC7FE94-7A30-4AC3-8182-D18840EBF999%7D&amp;ed=FIELD1148608540&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H1148608604&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Tujula B, Hämäläinen S, Kokki H, Pulkki K, Kokki M, Review of clinical practice guidelines on the use of procalcitonin in infections. Infect Dis (Lond) 2020;52: 227-234" data-value-piped="Tujula B, Hämäläinen S, Kokki H, Pulkki K, Kokki M|Review of clinical practice guidelines on the use of procalcitonin in infections.|Infect Dis (Lond)|2020|52|227-234|31858869" data-url="reference-link" data-pubmedid="31858869" title="Tujula B, Hämäläinen S, Kokki H, Pulkki K, Kokki M, Review of clinical practice guidelines on the use of procalcitonin in infections. Infect Dis (Lond) 2020;52: 227-234">2</a>&nbsp;</h2>
<ul>
    <li>Der er ikke indikation for at anvende analysen i almen praksis</li>
    <li>Mistanke om sv&aelig;r bakteriel infektion hos kritisk syge patienter, herunder is&aelig;r patienter med&nbsp;<a href="~/link.aspx?_id=599DCA34851A4CAFA0F5F48B6740EDE6&amp;_z=z">sepsis</a>&nbsp;hvor&nbsp;<a href="~/link.aspx?_id=F10DDAF5C6D84D01874EFE1D27450A03&amp;_z=z">C-reaktivt protein (CRP)</a>&nbsp;kan v&aelig;re forh&oslash;jet af anden &aring;rsag, f.eks. efter et traume, en st&oslash;rre operation, eller ved udbredt cancer
    <ul>
        <li>PCT har muligvis en s&aelig;rlig v&aelig;rdi i diagnosen af infektioner i den sene inflammatoriske fase, der f.eks. ofte ses 1 uge efter sv&aelig;re traumer (systemic inflammatory respons syndrome; SIRS)</li>
    </ul>
    </li>
    <li>Differentiering mellem alvorlige bakterielle, fungale eller parasit&aelig;re infektioner og virusinfektioner eller ikke-infekti&oslash;se &aring;rsager, f.eks. ved&nbsp;<a href="~/link.aspx?_id=F3A8C1841AE940BEB4FC3C18F07ACCB8&amp;_z=z">meningitis</a>&nbsp;eller&nbsp;<a href="~/link.aspx?_id=C0137DD2232646F6AD549B643A06B77F&amp;_z=z">pneumoni</a>, herunder is&aelig;r hos b&oslash;rn
    <ul>
        <li>PCT har muligvis en s&aelig;rlig differentialdiagnostisk v&aelig;rdi ved<a href="~/link.aspx?_id=EC3545171DD64CAD9093EBE2ACD04B5F&amp;_z=z">&nbsp;acute respiratory distress syndrome (ARDS)</a></li>
    </ul>
    </li>
    <li>Mistanke om&nbsp;<a href="~/link.aspx?_id=236AB7356E084412B05B180575D81C86&amp;_z=z">infekti&oslash;s endokardit</a></li>
    <li>Monitorering af patienter i behandling for sv&aelig;re infektioner. Man kan f.eks. foretage daglige m&aring;linger og bruge et fald i PCT som udtryk for en effektiv antibiotikabehandling, og en vedvarende forh&oslash;jet eller stigende v&aelig;rdi som indikation for at &aelig;ndre behandlingen</li>
    <li>Ved covid-19 infektioner tyder forh&oslash;jet PCT p&aring; et alvorligt forl&oslash;b&nbsp;<a href="EditorPage.aspx?da=core&amp;id=%7BEAC7FE94-7A30-4AC3-8182-D18840EBF999%7D&amp;ed=FIELD1148608540&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H1148608604&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Malik P, Patel U, Mehta D, Patel N, Kelkar R, Akrmah M, Gabrilove JL, Sacks H, Biomarkers and outcomes of COVID-19 hospitalisations: systematic review and meta-analysis. BMJ Evid Based Med 2021;26: 107-108" data-value-piped="Malik P, Patel U, Mehta D, Patel N, Kelkar R, Akrmah M, Gabrilove JL, Sacks H|Biomarkers and outcomes of COVID-19 hospitalisations: systematic review and meta-analysis.|BMJ Evid Based Med|2021|26|107-108|32934000" data-url="reference-link" data-pubmedid="32934000" title="Malik P, Patel U, Mehta D, Patel N, Kelkar R, Akrmah M, Gabrilove JL, Sacks H, Biomarkers and outcomes of COVID-19 hospitalisations: systematic review and meta-analysis. BMJ Evid Based Med 2021;26: 107-108">5</a></li>
</ul>
<h2>Fortolkninger<a href="EditorPage.aspx?da=core&amp;id=%7BEAC7FE94-7A30-4AC3-8182-D18840EBF999%7D&amp;ed=FIELD17668609993&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H17668610203&amp;us=sitecore%5Canvi&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Taylor R, Jones A, Kelly S, Simpson M, Mabey J, A Review of the Value of Procalcitonin as a Marker of Infection.. Cureus 2017;9: e1148" data-value-piped="Taylor R, Jones A, Kelly S, Simpson M, Mabey J|A Review of the Value of Procalcitonin as a Marker of Infection.|Cureus|2017|9|e1148|28497010" data-url="reference-link" data-pubmedid="28497010" title="Taylor R, Jones A, Kelly S, Simpson M, Mabey J, A Review of the Value of Procalcitonin as a Marker of Infection.. Cureus 2017;9: e1148">3</a><sup>,</sup><a href="EditorPage.aspx?da=core&amp;id=%7BEAC7FE94-7A30-4AC3-8182-D18840EBF999%7D&amp;ed=FIELD17668609993&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H17668610203&amp;us=sitecore%5Canvi&amp;mo&amp;pe=0&amp;fbd=1" data-type="book-reference" data-value="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. . Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010" data-value-piped="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. |Lyngbyes laboratoriemedicin. 2. udg.|København|Nyt Nordisk Forlag Arnold Busck A/S|2010" data-url="reference-link" data-pubmedid="undefined" title="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. . Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010">4</a></h2>
<ul>
    <li>Ved mistanke om systemisk bakteriel infektion, f.eks.&nbsp;<a href="~/link.aspx?_id=599DCA34851A4CAFA0F5F48B6740EDE6&amp;_z=z">sepsis</a>
    <ul>
        <li>Under 0,5 &micro;g/L &mdash; usandsynligt</li>
        <li>0,5 - 2,0 &micro;g/L &mdash; muligt, is&aelig;r hvis der er set en stigning over flere dage</li>
        <li>2,1 - 10,0 &micro;g/L &mdash; sandsynlig</li>
        <li>Over 10,0 &micro;g/L &mdash; h&oslash;jst sandsynlig</li>
    </ul>
    </li>
    <li>Ved&nbsp;<a href="~/link.aspx?_id=236AB7356E084412B05B180575D81C86&amp;_z=z">infekti&oslash;s endocardit</a>&nbsp;ses typisk v&aelig;rdier over 2,3 &micro;g/L</li>
    <li>Forh&oslash;jede og is&aelig;r vedvarende forh&oslash;jede v&aelig;rdier er et d&aring;rligt prognostisk tegn ved en r&aelig;kke alvorligere infektionssygdomme og/eller efter operationer med komplikationer, f.eks. tilstande med peritonitis</li>
    <li>Patienter med multiorgansvigt har h&oslash;je v&aelig;rdier</li>
    <li>Forh&oslash;jede v&aelig;rdier kan i sj&aelig;ldne tilf&aelig;lde skyldes produktion fra en medul&aelig;r thyroideacancer, eller f.eks. fra lungecancer. I disse tilf&aelig;lde vil&nbsp;<a href="~/link.aspx?_id=206CC9CD0FE14571BF1F716FE550CC73&amp;_z=z">calcitonin</a>&nbsp;ogs&aring; v&aelig;re forh&oslash;jet</li>
    <li>Procalcitonin er forh&oslash;jet ved b&aring;de septisk artrit og akut artritis urica. Derfor er m&aring;ling af procalcitonin uegnet til at skelne mellem infektion og akut artritis urica</li>
</ul>
<h2>Fejlkilder (og kilder til normal variation)</h2>
<ul>
    <li>Ingen kendte fejlkilder</li>
</ul>
<h2>Biokemisk baggrund</h2>
<ul>
    <li>Procalcitonin (PCT) dannes som et prohormon (forstadie) til calcitonin i C-cellerne i gl. thyroidea, men produceres ogs&aring; i en r&aelig;kke andre celler og v&aelig;v som reaktion p&aring; sepsis, udbredte og invasive infektioner med bakterier, svampe og parasitter, men ikke ved virusinfektioner eller ved aseptiske inflammatoriske tilstande </li>
    <li>Funktionen er delvist ukendt, men PCT menes at indg&aring; i organismens cytokine inflammatoriske reaktion og dermed immunsystemets funktion </li>
    <li>PCT stiger hurtigt ved sv&aelig;re infektioner og falder hurtigt igen, hvis tilstanden bedres</li>
</ul>
<h2>Pr&oslash;vetagning</h2>
<ul>
    <li>Vene- eller arterieblod i r&oslash;r uden antikoagulans (t&oslash;rglas) eller EDTA-r&oslash;r</li>
    <li>Afpipetteret serum eller plasma er holdbart i 1 d&oslash;gn ved stuetemperatur og op til 4 d&oslash;gn ved 4<sup>o</sup>C</li>
    <li><a href="~/link.aspx?_id=19A739878E974B0D91C2ED30FA78A047&amp;_z=z">Hypertriglycerid&aelig;mi</a>&nbsp;og/eller hyperbilirubin&aelig;mi kan umuligg&oslash;re analysen</li>
</ul>
<h2>Referenceintervaller</h2>
<ul>
    <li>Der kan v&aelig;re forskelle i de angivne v&aelig;rdier fra laboratorium til laboratorium, afh&aelig;ngigt af de anvendte m&aring;lemetoder</li>
    <li>Under 0,5 &micro;g/L</li>
</ul>
<h2>NPU-koder og -navne</h2>
<ul>
    <li>NPU21576 P&mdash;Procalcitonin; massek. = ? &micro;g/L</li>
</ul>
<ul>
    <li><strong>Kort navn</strong>
    <ul>
        <li>Procalcitonin;P</li>
    </ul>
    </li>
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