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World J Gastroenterol. Dec 21, 2017; 23(47): 8283-8290
Published online Dec 21, 2017. doi: 10.3748/wjg.v23.i47.8283
Procalcitonin in inflammatory bowel disease: Drawbacks and opportunities
Giuseppe Lippi, Fabian Sanchis-Gomar
Giuseppe Lippi, Section of Clinical Biochemistry, University of Verona, Verona 37134, Italy
Fabian Sanchis-Gomar, Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY 10016, United States
Fabian Sanchis-Gomar, Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia 46010, Spain
Author contributions: Lippi G and Sanchis-Gomar F contributed equally to this work, generated the figures and wrote the manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giuseppe Lippi, MD, Professor, Section of Clinical Biochemistry, University Hospital of Verona, Piazzale L.A. Scuro 10, Verona 37134, Italy. giuseppe.lippi@univr.it
Telephone: + 39-45-8124308
Received: October 28, 2017
Peer-review started: October 29, 2017
First decision: November 21, 2017
Revised: November 27, 2017
Accepted: December 4, 2017
Article in press: December 4, 2017
Published online: December 21, 2017
Processing time: 52 Days and 10.3 Hours
Abstract

The measurement of procalcitonin has recently become a mainstay for the diagnosis and therapeutic management of severe bacterial infections, especially those sustained by Gram-negative bacteria. Therefore, the aim of this article is to provide a narrative overview on the potential role of procalcitonin measurement in patients with inflammatory bowel disease (IBD). According to the available scientific literature, the clinical significance of procalcitonin for diagnosing IBD or monitoring disease activity remains elusive, and its association with disease severity is confined to a limited number of case-control studies, with low sample size. Nevertheless, literature data also suggests that a supranormal procalcitonin serum concentration (i.e., > 0.5 ng/mL) may reflect the presence of a number of infective complications in IBD, especially bacterial enterocolitis, bacterial gastroenteritis, intraabdominal abscess, postsurgical infection and sepsis. Rather than for diagnosing or assessing disease activity, the measurement of this biomarker may hence retain practical clinical significance for early prediction, timely diagnosis and therapeutic monitoring of many IBD-associated infections and complications.

Keywords: Intestinal bowel disease; Chron’s disease; Ulcerative colitis; Procalcitonin

Core tip: According to current evidence, the clinical significance of measuring procalcitonin for diagnosing intestinal bowel disease (IBD) or monitoring disease activity remains elusive. Nevertheless, literature data suggests that supranormal procalcitonin concentrations may reflect the presence of a number of infective complications in IBD, including bacterial enterocolitis, bacterial gastroenteritis, intraabdominal abscess, postsurgical infection and sepsis. Rather than for assessing disease activity, the measurement of this biomarker may hence retain clinical significance for predicting or timely diagnosing of many IBD-associated infections and complications.