{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:42:41Z","timestamp":1759970561943,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T00:00:00Z","timestamp":1737763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research, Development and Innovation Fund","award":["2024-2.1.2-EK\u00d6P-KDP-2024-00002","EK\u00d6P-2024-174"],"award-info":[{"award-number":["2024-2.1.2-EK\u00d6P-KDP-2024-00002","EK\u00d6P-2024-174"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: This review examines the role of serum procalcitonin (PCT) as a diagnostic marker for sepsis and its potential implications in anaphylaxis. Elevated PCT levels, often associated with bacterial infections, can complicate diagnosis when seen in anaphylaxis, especially when clinical features overlap with sepsis. Methods: We conducted a literature review on PCT in anaphylaxis to highlight key patterns and present two cases of anaphylactic shock initially misdiagnosed as sepsis due to elevated PCT levels. Results: The review supports that elevated PCT can occur in anaphylaxis, stressing the need for thorough patient history and symptom evaluation. In both cases, elevated PCT led to initial sepsis diagnoses, but further investigation identified anaphylaxis triggered by sulfamethoxazole\/trimethoprim (SMX\/TMP). Conclusions: These findings emphasize the need for considering anaphylaxis in differential diagnoses when elevated PCT levels are observed. Increased awareness of PCT\u2019s potential association with allergic drug reactions is essential to ensure timely recognition, avoid diagnostic delays, and improve patient outcomes.<\/jats:p>","DOI":"10.3390\/jcm14030785","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T07:54:08Z","timestamp":1738050848000},"page":"785","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Anaphylaxis with Elevated Procalcitonin Mimicking Sepsis: A Literature Review and Report of Two Cases"],"prefix":"10.3390","volume":"14","author":[{"given":"Andr\u00e1s","family":"B\u00e1nv\u00f6lgyi","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kende","family":"L\u0151rincz","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9728-1117","authenticated-orcid":false,"given":"Mehdi","family":"Boostani","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1260-3960","authenticated-orcid":false,"given":"Efrat","family":"Bar-Ilan","sequence":"additional","affiliation":[{"name":"Pediatric Dermatology Department, Heim P\u00e1l National Children\u2019s Institute, 1089 Budapest, Hungary"},{"name":"Pediatric Dermatology Unit, Dermatology Department, Sheba Medical Center, Ramat Gan 5262160, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernadett","family":"Hidv\u00e9gi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3126-096X","authenticated-orcid":false,"given":"M\u00e1rta","family":"Medvecz","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Kiss","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert M.","family":"Wikonk\u00e1l","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.14785\/lymphosign-2018-0001","article-title":"C-reactive protein and other biomarkers\u2014The sense and non-sense of using inflammation biomarkers for the diagnosis of severe bacterial infection","volume":"5","author":"Niehues","year":"2018","journal-title":"LymphoSign J."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ramasco, F., M\u00e9ndez, R., Suarez de la Rica, A., Gonz\u00e1lez de Castro, R., and Maseda, E. (2024). Sepsis Stewardship: The puzzle of antibiotic therapy in the context of individualization of decision making. J. Pers. Med., 14.","DOI":"10.3390\/jpm14010106"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1080\/14737159.2024.2392283","article-title":"Towards improved point-of-care (POC) testing for patients with suspected sepsis: POC tests for host biomarkers and possible microbial pathogens","volume":"24","author":"Adami","year":"2024","journal-title":"Expert Rev. Mol. Diagn."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"P205","DOI":"10.1186\/cc14285","article-title":"Admissions with airway emergencies in the ICU at a tertiary referral centre","volume":"19","author":"Gresoiu","year":"2015","journal-title":"Crit. Care"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Nguyen, S.M.T., Rupprecht, C.P., Haque, A., Pattanaik, D., Yusin, J., and Krishnaswamy, G. (2021). Mechanisms governing anaphylaxis: Inflammatory cells, mediators, endothelial gap junctions and beyond. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22157785"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.jaip.2018.10.020","article-title":"Differentiating acute food protein\u2013induced enterocolitis syndrome from its mimics: A comparison of clinical features and routine laboratory biomarkers","volume":"7","author":"Lee","year":"2019","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1097\/MD.0b013e3181a4d1a1","article-title":"Drug-induced hypersensitivity syndrome: Clinical and biologic disease patterns in 24 patients","volume":"88","author":"Blanche","year":"2009","journal-title":"Medicine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1016\/j.jaci.2009.07.055","article-title":"Elevated serum cytokines during human anaphylaxis: Identification of potential mediators of acute allergic reactions","volume":"124","author":"Stone","year":"2009","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s00011-012-0439-5","article-title":"Immune regulation of procalcitonin: A biomarker and mediator of infection","volume":"61","author":"Matwiyoff","year":"2012","journal-title":"Inflamm. Res."},{"key":"ref_10","unstructured":"Shtroblya, A., Drogovoz, S., Shchokina, K., Belik, G., Kire, I., Romanenko, K., and Stoletov, Y.V. (2021). Potential Risks of Sulfametoxazole\/Trimetoprim, SILAE."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0924-8579(02)00047-X","article-title":"Procalcitonin as a marker of sepsis","volume":"20","author":"Carrol","year":"2002","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1586\/erm.11.85","article-title":"How novel molecular diagnostic technologies and biomarkers are revolutionizing genetic testing and patient care","volume":"12","author":"Baudhuin","year":"2012","journal-title":"Expert Rev. Mol. Diagn."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1080\/13547500802645905","article-title":"Biosensors for biomarkers in medical diagnostics","volume":"13","author":"Mascini","year":"2008","journal-title":"Biomarkers"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Bozs\u00e1nyi, S., Boostani, M., Farkas, K., Hamilton-Meikle, P., Varga, N.N., Szab\u00f3, B., Vasanits, F., Kuroli, E., Meznerics, F.A., and L\u0151rincz, K. (2023). Optically Guided High-Frequency Ultrasound to Differentiate High-Risk Basal Cell Carcinoma Subtypes: A Single-Centre Prospective Study. J. Clin. Med., 12.","DOI":"10.3390\/jcm12216910"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Boostani, M., Bozs\u00e1nyi, S., Suppa, M., Cantisani, C., L\u0151rincz, K., B\u00e1nv\u00f6lgyi, A., Holl\u00f3, P., Wikonk\u00e1l, N.M., Huss, W.J., and Brady, K.L. (Int. J. Dermatol., 2024). Novel imaging techniques for tumor margin detection in basal cell carcinoma: A systematic scoping review of FDA and EMA-approved imaging modalities, Int. J. Dermatol., Online ahead of print.","DOI":"10.1111\/ijd.17496"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1039\/C5AN01790D","article-title":"Biomarker detection technologies and future directions","volume":"141","author":"Nimse","year":"2016","journal-title":"Analyst"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"9","DOI":"10.2144\/05384SU04","article-title":"Biomarkers in molecular medicine: Cancer detection and diagnosis","volume":"38","author":"Maruvada","year":"2005","journal-title":"Biotechniques"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez Ruiz, N., Abd Own, S., Ekstr\u00f6m Smedby, K., Eloranta, S., Koch, S., W\u00e4sterlid, T., Krstic, A., and Boman, M. (2022). Data-driven support to decision-making in molecular tumour boards for lymphoma: A design science approach. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.984021"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e233521","DOI":"10.1136\/bcr-2019-233521","article-title":"Electrocardiographic alterations and raised procalcitonin levels during anaphylactic shock","volume":"13","author":"Mirijello","year":"2020","journal-title":"BMJ Case Rep. CP"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Al Hillan, A., Ajam, F., and Khan, T. (2019). Elevated Serum Procalcitonin in the Setting of Allergic Reaction:-A Marker of Anaphylaxis. D31 Allergy and Asthma Case Reports, American Thoracic Society.","DOI":"10.1164\/ajrccm-conference.2019.199.1_MeetingAbstracts.A6120"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.ijid.2015.06.012","article-title":"Marked elevation of procalcitonin level can lead to a misdiagnosis of anaphylactic shock as septic shock","volume":"37","author":"Kim","year":"2015","journal-title":"Int. J. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Mann, J., and Cavallazzi, R. (2014). Marked serum procalcitonin level in response to isolated anaphylactic shock. Am. J. Emerg. Med., 33.","DOI":"10.1016\/j.ajem.2014.05.053"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1093\/jac\/dkt076","article-title":"Elevated serum procalcitonin in anaphylaxis","volume":"68","author":"Hounoki","year":"2013","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Song, G., Cheng, M.-Q., Li, R., Zhang, C.-Q., and Sun, P. (2022). Drug-induced hypersensitivity syndrome with high procalcitonin levels due to piperacillin\/tazobactam and meropenem: A case report. Front. Med., 9.","DOI":"10.3389\/fmed.2022.951714"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"121","DOI":"10.2147\/JAA.S159411","article-title":"Anaphylaxis in the 21st century: Phenotypes, endotypes, and biomarkers","volume":"11","author":"Alenazy","year":"2018","journal-title":"J. Asthma Allergy"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2050313X241285675","DOI":"10.1177\/2050313X241285675","article-title":"Fever and reversible laboratory abnormalities associated with prolonged use of piperacillin\/tazobactam: A case report","volume":"12","author":"Shen","year":"2024","journal-title":"SAGE Open Med. Case Rep."},{"key":"ref_27","first-page":"S57","article-title":"Physiology and genetics of procalcitonin","volume":"49","author":"Maruna","year":"2000","journal-title":"Physiol. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"S153","DOI":"10.1007\/s001340051135","article-title":"Procalcitonin (PCT) is useful in predicting the bacterial origin of an acute circulatory failure in critically ill patients","volume":"26","author":"Cheval","year":"2000","journal-title":"Intensive Care Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/785\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:36:02Z","timestamp":1759919762000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/785"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,25]]},"references-count":28,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14030785"],"URL":"https:\/\/doi.org\/10.3390\/jcm14030785","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,1,25]]}}}