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Clinical Chemistry 45: 441, 1999;
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(Clinical Chemistry. 1999;45:441.)
© 1999 American Association for Clinical Chemistry, Inc.

Letters

The authors of the report cited above respond:

Christopher Sachsea, Frank Dressler and Eberhard Henkel

Medical School Hannover, Department of Clinical Chemistry II, and Department of Pediatrics, Podbielskistrasee 380, 30659 Hannover, Germany
a Author for correspondence.


To the Editor:

We appreciate the comments of Dr. Martin-Denavit and co-workers on our report and the information they presented, which throws additional light on the use of serum procalcitonin (PCT) for the diagnosis of neonatal infection. They regard markedly increased serum PCT as a marker of materno-fetal infection, although fetal involvement is difficult to confirm. In the absence of microbiological evidence, the diagnosis of infection relies on clinical signs, which can be found in a variety of conditions. Alternatively, the high serum PCT concentrations measured in eight neonates could represent maternal PCT, increased by an infection not involving the fetus, after passage through the placenta. Given the low molecular mass ({approx}12 kDa) of PCT (1), transplacental passage of this substance must be considered, although we are not aware of any study dealing with this issue. Parallel measurements of maternal and neonatal serum PCT concentrations at delivery could give insight into the possible sources of increased PCT in the first hours of life.

Regarding the serum PCT concentrations in newborn infants without infection, the data presented by Dr. Martin-Denavit and co-workers combine with those presented by another group (2) and our group to give a clearer picture of a physiological peak in serum PCT occurring between 12 and 36 h after birth. Physiological peak PCT concentrations generally are <20 µg/L; therefore, values exceeding that limit can be regarded as a sign of infection even in this time period.


References

  1. LeMoullec JM, Jullienne A, Chenais J, Lasmoles F, Guliana JM, Milhaud G, Moukhtar MS. The complete sequence of human preprocalcitonin. FEBS Lett 1984;167:93-97.[ISI][Medline] [Order article via Infotrieve]
  2. Chiesa C, Panero A, Rossi N, Stegagno M, DeGiusti M, Osborn JF, Pacifico L. Reliability of procalcitonin concentrations for the diagnosis of sepsis in critically ill neonates. Clin Infect Dis 1998;26:664-672.[ISI][Medline] [Order article via Infotrieve]



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M. Assumma, F. Signore, L. Pacifico, N. Rossi, J. F. Osborn, and C. Chiesa
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This Article
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Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (2)
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Google Scholar
Right arrow Articles by Sachse, C.
Right arrow Articles by Henkel, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sachse, C.
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Related Collections
Right arrow Pediatric Clinical Chemistry
Right arrow Endocrinology and Metabolism

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