Not Every Rise in Procalcitonin is Infection

Procalcitonin (PCT) a peptide precursor of the hormone calcitonin, is produced by the parafollicular cells (C cells) of the thyroid and by the neuro-endocrine cells of the lung and the intestine. PCT level has been shown to rise in response to proinflammatory stimulus, especially of bacterial origin and in this case, it is produced mainly by the cells of the lung and the intestine. Measurement of PCT can be used as a marker of severe sepsis caused by bacteria and generally grades well with the degree of sepsis. Use of PCT has been advocated to assist in decisions about initiation of antibiotic therapy in patients with presumed infection. Currently, PCT assays are widely used in the clinical environment. However, every rise in PCT is not indicative of infection, and other non-infectious inflammatory causes should also be kept in mind. We report a case of highly elevated PCT that was not an infection.

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