{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:17:13Z","timestamp":1792819033065,"version":"4.5.0"},"reference-count":118,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Procalcitonin (PCT) is widely used to support the diagnosis of bacterial infection and sepsis, yet clinically relevant elevations also occur in multiple non-infectious conditions. This systematic review aimed to synthesize human evidence on non-infectious causes of elevated PCT and to summarize proposed pathophysiological mechanisms, with the goal of supporting context-based interpretation in clinical practice. Materials and Methods: A systematic search of PubMed\/MEDLINE, Embase, Web of Science, and Scopus was performed from inception to 31 July 2025. Human studies published in English reporting quantitative PCT values in non-infectious contexts were eligible (observational studies, clinical trials, and case series with \u22655 patients). Results: Seventy-six unique studies were included. Evidence was organized across systemic inflammatory responses, cardiovascular pathology, nephrological disorders and renal replacement therapy, pulmonary diseases, gastrointestinal and hepatopancreatic diseases, autoimmune and rheumatologic conditions, neurologic and ophthalmologic conditions, onco-hematologic disorders, surgery, traumatology and transplanted patients. Across conditions, non-infectious PCT elevations were variable and frequently overlapped with ranges reported in bacterial infection, particularly in settings characterized by severe sterile inflammation and tissue injury (e.g., major surgery, trauma, shock, pancreatitis, and burns), as well as in selected malignancies with tumor-associated PCT production. Conclusions: Elevated PCT is not synonymous with bacterial infection. Interpretation should emphasize clinical context, timing, and serial trends rather than isolated thresholds, especially in high-acuity settings with strong non-infectious inflammatory stimuli. Standardized reporting of assays and sampling time points and condition-specific kinetic data are needed to refine diagnostic and stewardship algorithms.<\/jats:p>","DOI":"10.3390\/medicina62030464","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T16:06:59Z","timestamp":1772467619000},"page":"464","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Non-Infectious Causes for Elevated Procalcitonin"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5508-2598","authenticated-orcid":false,"given":"Stefan Lucian","family":"Popa","sequence":"first","affiliation":[{"name":"2nd Medical Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4418-6465","authenticated-orcid":false,"given":"Victor","family":"Incze","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7435-271X","authenticated-orcid":false,"given":"Abdulrahman","family":"Ismaiel","sequence":"additional","affiliation":[{"name":"2nd Medical Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6020-4724","authenticated-orcid":false,"given":"Teodora","family":"Surdea-Blaga","sequence":"additional","affiliation":[{"name":"2nd Medical Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2951-7085","authenticated-orcid":false,"given":"Simona","family":"Grad","sequence":"additional","affiliation":[{"name":"2nd Medical Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9062-9919","authenticated-orcid":false,"given":"Daria Claudia","family":"Turtoi","sequence":"additional","affiliation":[{"name":"Department of Radiology, County University Emergency Hospital, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8382-0919","authenticated-orcid":false,"given":"Darius-Stefan","family":"Amarie","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5442-3138","authenticated-orcid":false,"given":"Liliana","family":"David","sequence":"additional","affiliation":[{"name":"2nd Medical Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0007-8962","authenticated-orcid":false,"given":"Vlad Dumitru","family":"Brata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Regional Institute of Gastroenterology and Hepatology \u201cProf. Dr. Octavian Fodor\u201d, 400394 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4218-8622","authenticated-orcid":false,"given":"Daniel Corneliu","family":"Leucuta","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Biostatistics, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abdelghafar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia Diana","family":"Gherman","sequence":"additional","affiliation":[{"name":"Department of Surgery-Practical Abilities, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai Razvan","family":"Zahan","sequence":"additional","affiliation":[{"name":"2nd Medical Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinu Iuliu","family":"Dumitrascu","sequence":"additional","affiliation":[{"name":"Department of Anatomy, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/0014-5793(84)80839-X","article-title":"The complete sequence of human preprocalcitonin","volume":"167","author":"Jullienne","year":"1984","journal-title":"FEBS Lett."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/0140-6736(93)90277-N","article-title":"High serum procalcitonin concentrations in patients with sepsis and infection","volume":"341","author":"Assicot","year":"1993","journal-title":"Lancet"},{"key":"ref_3","first-page":"1605","article-title":"Procalcitonin increase after endotoxin injection in normal subjects","volume":"79","author":"Dandona","year":"1994","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Duan, S., Gu, X., Fan, G., Zhou, F., Zhu, G., and Cao, B. (2021). C-reactive protein or procalcitonin combined with rhinorrhea for discrimination of viral from bacterial infections in hospitalized adults in non-intensive care units with lower respiratory tract infections. BMC Pulm. Med., 21.","DOI":"10.1186\/s12890-021-01672-7"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"8283","DOI":"10.3748\/wjg.v23.i47.8283","article-title":"Procalcitonin in inflammatory bowel disease: Drawbacks and opportunities","volume":"23","author":"Lippi","year":"2017","journal-title":"World J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Schuetz, P., Albrich, W., and Mueller, B. (2011). Procalcitonin for diagnosis of infection and guide to antibiotic decisions: Past, present and future. BMC Med., 9.","DOI":"10.1186\/1741-7015-9-107"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1183\/09031936.00166106","article-title":"Biomarkers in respiratory tract infections: Diagnostic guides to antibiotic prescription, prognostic markers and mediators","volume":"30","year":"2007","journal-title":"Eur. Respir. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"R83","DOI":"10.1186\/cc7903","article-title":"Procalcitonin to guide duration of antibiotic therapy in intensive care patients: A randomized prospective controlled trial","volume":"13","author":"Hochreiter","year":"2009","journal-title":"Crit. Care"},{"key":"ref_9","first-page":"CD007498","article-title":"Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections","volume":"10","author":"Schuetz","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1210\/jc.2002-021444","article-title":"Clinical review 167: Procalcitonin the calcitonin gene family of peptides in inflammation infection sepsis: A journey from calcitonin back to its precursors","volume":"89","author":"Becker","year":"2004","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1309\/AJCP1MFYINQLECV2","article-title":"Procalcitonin as a marker for the detection of bacteremia and sepsis in the emergency department","volume":"135","author":"Riedel","year":"2011","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.cca.2019.06.010","article-title":"Procalcitonin: Between evidence and critical issues","volume":"496","author":"Aloisio","year":"2019","journal-title":"Clin. Chim. Acta"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1080\/14737159.2018.1407244","article-title":"Novel applications for serum procalcitonin testing in clinical practice","volume":"18","author":"Choi","year":"2018","journal-title":"Expert. Rev. Mol. Diagn."},{"key":"ref_14","unstructured":"Cleland, D.A., and Eranki, A.P. (2025, October 24). Procalcitonin. [Updated 2023 Apr 23], StatPearls [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK539794\/."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jclinepi.2021.03.001","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"134","author":"Page","year":"2021","journal-title":"J. Clin. Epidemiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S0167-5273(99)00118-7","article-title":"Pyrexia, procalcitonin, immune activation and survival in cardiogenic shock: The potential importance of bacterial translocation","volume":"72","author":"Brunkhorst","year":"1999","journal-title":"Int. J. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1097\/00003246-200004000-00007","article-title":"Relationship between procalcitonin plasma levels and severity of injury, sepsis, organ failure, and mortality in injured patients","volume":"28","author":"Wanner","year":"2000","journal-title":"Crit. Care Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/00000542-199807000-00016","article-title":"Hyperprocalcitonemia in patients with noninfectious SIRS and pulmonary dysfunction associated with cardiopulmonary bypass","volume":"89","author":"Hensel","year":"1998","journal-title":"Anesthesiology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2172","DOI":"10.1097\/00003246-199910000-00016","article-title":"Discrimination of infectious and noninfectious causes of early acute respiratory distress syndrome by procalcitonin","volume":"27","author":"Brunkhorst","year":"1999","journal-title":"Crit. Care Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1097\/00003246-199708000-00024","article-title":"Effect of classic heatstroke on serum procalcitonin","volume":"25","author":"Becker","year":"1997","journal-title":"Crit. Care Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/2052-0492-2-35","article-title":"Procalcitonin for the differential diagnosis of infectious and non-infectious systemic inflammatory response syndrome after cardiac surgery","volume":"2","author":"Zhao","year":"2014","journal-title":"J. Intensive Care."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Lee, S., Song, J., Park, D.W., Seok, H., Ahn, S., Kim, J., Park, J., Cho, H.J., and Moon, S. (2022). Diagnostic and prognostic value of presepsin and procalcitonin in non-infectious organ failure, sepsis, and septic shock: A prospective observational study according to the Sepsis-3 definitions. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-021-07012-8"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.ijcard.2014.08.106","article-title":"Determinants of procalcitonin concentration in acute heart failure","volume":"177","author":"Mollar","year":"2014","journal-title":"Int. J. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.ijcard.2016.10.038","article-title":"Inflammation versus mechanical stretch biomarkers over time in acutely decompensated heart failure with reduced ejection fraction","volume":"226","author":"Boulogne","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1080\/AC.70.4.3096896","article-title":"Procalcitonin: A marker of heart failure","volume":"70","author":"Canbay","year":"2015","journal-title":"Acta Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.ajem.2013.12.045","article-title":"Thirty and ninety days mortality predictive value of admission and in-hospital procalcitonin and mid-regional pro-adrenomedullin testing in patients with dyspnea. Results from the VERyfing DYspnea trial","volume":"32","author":"Travaglino","year":"2014","journal-title":"Am. J. Emerg. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.ejim.2014.12.009","article-title":"Procalcitonin and long-term prognosis after an admission for acute heart failure","volume":"26","author":"Villanueva","year":"2015","journal-title":"Eur. J. Intern. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"651","DOI":"10.2217\/bmm.15.29","article-title":"Should procalcitonin be measured routinely in acute decompensated heart failure?","volume":"9","author":"Loncar","year":"2015","journal-title":"Biomark. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1007\/s12028-009-9325-6","article-title":"Usefulness of serum procalcitonin levels for the early diagnosis of stroke-associated respiratory tract infections","volume":"14","author":"Hug","year":"2011","journal-title":"Neurocrit. Care"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1007\/s12035-015-9112-7","article-title":"Procalcitonin Is a Stronger Predictor of Long-Term Functional Outcome and Mortality than High-Sensitivity C-Reactive Protein in Patients with Ischemic Stroke","volume":"53","author":"Wang","year":"2016","journal-title":"Mol. Neurobiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1253\/circj.CJ-10-0638","article-title":"Association of serum procalcitonin with cardiovascular prognosis in coronary artery disease","volume":"75","author":"Sinning","year":"2011","journal-title":"Circ. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1007\/s00134-003-1664-8","article-title":"Procalcitonin and C-reactive protein plasma concentrations in nonseptic uremic patients undergoing hemodialysis","volume":"29","author":"Dahaba","year":"2003","journal-title":"Intensive Care Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/j.0300-9475.2005.01545.x","article-title":"Modulation and source of procalcitonin in reduced renal function and renal replacement therapy","volume":"61","author":"Klein","year":"2005","journal-title":"Scand. J. Immunol."},{"key":"ref_34","first-page":"33","article-title":"Inflammation markers, chronic kidney disease, and renal replacement therapy","volume":"27","year":"2011","journal-title":"Adv. Perit. Dial."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1159\/000045570","article-title":"Procalcitonin in patients undergoing chronic hemodialysis","volume":"84","author":"Schmidt","year":"2000","journal-title":"Nephron"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1093\/ndt\/16.5.980","article-title":"Procalcitonin: A new marker of inflammation in haemodialysis patients?","volume":"16","author":"Level","year":"2001","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1081\/JDI-65200","article-title":"Relevance of procalcitonin levels in comparison to other markers of inflammation in hemodialysis patients","volume":"27","author":"Visvardis","year":"2005","journal-title":"Ren Fail."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1007\/s00467-006-0304-2","article-title":"Procalcitonin serum levels in children undergoing chronic haemodialysis","volume":"22","author":"Lorton","year":"2007","journal-title":"Pediatr. Nephrol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"703","DOI":"10.3109\/00365510902993663","article-title":"Procalcitonin values after dialysis is closely related to type of dialysis membrane","volume":"69","author":"Montagnana","year":"2009","journal-title":"Scand. J. Clin. Lab. Investig."},{"key":"ref_40","first-page":"411","article-title":"Pro-calcitonin and inflammation in chronic hemodialysis","volume":"73","author":"Trimarchi","year":"2013","journal-title":"Medicina (B Aires)"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1177\/089686080502500511","article-title":"Procalcitonin levels in peritoneal dialysis patients","volume":"25","author":"Klaboch","year":"2005","journal-title":"Perit. Dial. Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1177\/089686080602600221","article-title":"Procalcitonin and conventional markers of inflammation in peritoneal dialysis patients and peritonitis","volume":"26","author":"Guz","year":"2006","journal-title":"Perit. Dial. Int."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1007\/s00508-004-0279-6","article-title":"Procalcitonin in patients with acute and chronic renal insufficiency","volume":"116","author":"Steinbach","year":"2004","journal-title":"Wien. Klin. Wochenschr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1111\/nep.13174","article-title":"Serum procalcitonin levels predict acute kidney injury in critically ill patients","volume":"23","author":"Jeeha","year":"2018","journal-title":"Nephrology (Carlton)"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s10096-010-1082-0","article-title":"Diagnostic value of procalcitonin in pleural effusions","volume":"30","author":"Wang","year":"2011","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Watanabe, N., Ishii, T., Kita, N., Kanaji, N., Nakamura, H., Nanki, N., Ueda, Y., Tojo, Y., Kadowaki, N., and Bandoh, S. (2018). The usefulness of pleural fluid presepsin, C-reactive protein, and procalcitonin in distinguishing different causes of pleural effusions. BMC Pulm. Med., 18.","DOI":"10.1186\/s12890-018-0740-3"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1016\/j.ajem.2012.04.009","article-title":"Evaluation of mid-regional pro-atrial natriuretic peptide, procalcitonin, and mid-regional pro-adrenomedullin for the diagnosis and risk stratification of dyspneic ED patients","volume":"30","author":"Cinar","year":"2012","journal-title":"Am. J. Emerg. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.amjmed.2015.06.037","article-title":"Global Research on Acute Conditions Team (GREAT) Network. Diagnostic Prognostic Utility of Procalcitonin in Patients Presenting to the Emergency Department with Dyspnea","volume":"129","author":"Alba","year":"2016","journal-title":"Am. J. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/00042737-200605000-00012","article-title":"Clinical significance of serum procalcitonin levels in patients with acute or chronic liver disease","volume":"18","author":"Elefsiniotis","year":"2006","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Oruc, N., Ozutemiz, O., Yuce, G., Akarca, U.S., Ersoz, G., Gunsar, F., and Batur, Y. (2009). Serum procalcitonin and CRP levels in non-alcoholic fatty liver disease: A case control study. BMC Gastroenterol., 9.","DOI":"10.1186\/1471-230X-9-16"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.lab.2005.08.005","article-title":"Serum levels of C-reactive protein and procalcitonin in critically ill patients with cirrhosis of the liver","volume":"146","author":"Bota","year":"2005","journal-title":"J. Lab. Clin. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1111\/jgh.13928","article-title":"Adding C-reactive protein and procalcitonin to the model of end-stage liver disease score improves mortality prediction in patients with complications of cirrhosis","volume":"33","author":"Chirapongsathorn","year":"2018","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"388","DOI":"10.12701\/jyms.2023.00059","article-title":"Diagnostic value of serum procalcitonin and C-reactive protein in discriminating between bacterial and nonbacterial colitis: A retrospective study","volume":"40","author":"Lee","year":"2023","journal-title":"J. Yeungnam Med. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/00003246-200101000-00016","article-title":"Procalcitonin, soluble interleukin-2 receptor, and soluble E-selectin in predicting the severity of acute pancreatitis","volume":"29","author":"Takala","year":"2001","journal-title":"Crit. Care Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1046\/j.1365-2168.2001.01673.x","article-title":"Procalcitonin strip test in the early detection of severe acute pancreatitis","volume":"88","author":"Takala","year":"2001","journal-title":"Br. J. Surg."},{"key":"ref_56","first-page":"115","article-title":"Procalcitonin is a predictive marker for severe acute pancreatitis","volume":"12","author":"Ayten","year":"2006","journal-title":"Ulus. Travma Acil Cerrahi Derg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1023\/A:1018887704337","article-title":"Diagnostic relevance of interleukin pattern, acute-phase proteins, and procalcitonin in early phase of post-ERCP pancreatitis","volume":"43","author":"Kunz","year":"1998","journal-title":"Dig. Dis. Sci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1023\/A:1005525329939","article-title":"Serum amyloid A, procalcitonin, and C-reactive protein in early assessment of severity of acute pancreatitis","volume":"45","author":"Pezzilli","year":"2000","journal-title":"Dig. Dis. Sci."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1093\/clinchem\/46.3.428","article-title":"Procalcitonin is not a reliable marker for the assessment of severity in acute pancreatitis without infectious complications","volume":"46","author":"Merlini","year":"2000","journal-title":"Clin. Chem."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1002\/1529-0131(199707)40:7<1250::AID-ART9>3.0.CO;2-A","article-title":"Usefulness of procalcitonin for differentiation between activity of systemic autoimmune disease (systemic lupus erythematosus\/systemic antineutrophil cytoplasmic antibody-associated vasculitis) and invasive bacterial infection","volume":"40","author":"Eberhard","year":"1997","journal-title":"Arthritis Rheum."},{"key":"ref_61","first-page":"303","article-title":"Diagnostic value of serum and synovial procalcitonin in acute arthritis: A prospective study of 42 patients","volume":"23","author":"Martinot","year":"2005","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.jinf.2003.08.002","article-title":"Serum procalcitonin concentration in patients with Kawasaki disease","volume":"48","author":"Okada","year":"2004","journal-title":"J. Infect."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.1097\/00003246-200006000-00024","article-title":"Serum procalcitonin levels in bacterial and abacterial meningitis","volume":"28","author":"Schwarz","year":"2000","journal-title":"Crit. Care Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"3401","DOI":"10.1007\/s10792-021-01903-0","article-title":"Evaluation of vitreous Procalcitonin as a diagnostic biomarker in infectious endophthalmitis","volume":"41","author":"Naik","year":"2021","journal-title":"Int. Ophthalmol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"434","DOI":"10.5603\/EP.a2017.0038","article-title":"Diagnostic value of selected biochemical markers in the detection of recurrence of medullary thyroid cancer\u2014Comparison of calcitonin, procalcitonin, chromogranin A, and carcinoembryonic antigen","volume":"68","author":"Kaznowski","year":"2017","journal-title":"Endokrynol. Pol."},{"key":"ref_66","first-page":"1035","article-title":"Non-infectious causes of elevated procalcitonin and C-reactive protein serum levels in pediatric patients with hematologic and oncologic disorders","volume":"16","author":"Dornbusch","year":"2008","journal-title":"Support. Care Cancer"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1038\/bmt.2012.18","article-title":"The clinical role of procalcitonin in hematopoietic SCT","volume":"47","author":"Koya","year":"2012","journal-title":"Bone Marrow Transplant."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1111\/j.1365-2141.2004.05053.x","article-title":"Prospective evaluation of procalcitonin in adults with febrile neutropenia after haematopoietic stem cell transplantation","volume":"126","author":"Ortega","year":"2004","journal-title":"Br. J. Haematol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1128\/CDLI.7.6.889-892.2000","article-title":"Procalcitonin does not discriminate infection from inflammation after allogeneic bone marrow transplantation","volume":"7","author":"Blijlevens","year":"2000","journal-title":"Clin. Diagn. Lab. Immunol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1007\/s00277-002-0584-y","article-title":"Procalcitonin: A useful discriminator between febrile conditions of different origin in hemato-oncological patients?","volume":"82","author":"Binder","year":"2003","journal-title":"Ann. Hematol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1111\/j.1469-0691.2004.00883.x","article-title":"Potential use of procalcitonin as a diagnostic criterion in febrile neutropenia: Experience from a multicentre study","volume":"10","author":"Giamarellou","year":"2004","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"910","DOI":"10.3109\/10428194.2014.938329","article-title":"Role of procalcitonin and C-reactive protein for discrimination between tumor fever and infection in patients with hematological diseases","volume":"56","author":"Hangai","year":"2015","journal-title":"Leuk. Lymphoma"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2462","DOI":"10.1002\/cncr.20275","article-title":"Assessment of procalcitonin as a diagnostic and prognostic marker in patients with solid tumors and febrile neutropenia","volume":"100","author":"Jimeno","year":"2004","journal-title":"Cancer"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.cccn.2003.10.014","article-title":"Procalcitonin levels in plasma in oncohaematologic patients with and without bacterial infections","volume":"340","author":"Ciaccio","year":"2004","journal-title":"Clin. Chim. Acta"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.clinbiochem.2006.10.027","article-title":"Evaluation of serum procalcitonin and interleukin-6 levels as markers of liver metastasis","volume":"40","author":"Matzaraki","year":"2007","journal-title":"Clin. Biochem."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.4103\/0366-6999.205857","article-title":"Early Kinetics of Procalcitonin in Predicting Surgical Outcomes in Type A Aortic Dissection Patients","volume":"130","author":"Liu","year":"2017","journal-title":"Chin. Med. J."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1177\/1457496916683096","article-title":"Elevated Levels of Procalcitonin and Interleukin-6 are Linked with Postoperative Complications in Cardiac Surgery","volume":"106","author":"Brocca","year":"2017","journal-title":"Scand. J. Surg."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1093\/bja\/83.4.602","article-title":"Effect of cardiopulmonary bypass on serum procalcitonin and C-reactive protein concentrations","volume":"83","author":"Aouifi","year":"1999","journal-title":"Br. J. Anaesth."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1055\/s-2003-45425","article-title":"Procalcitonin is a valuable prognostic marker in cardiac surgery but not specific for infection","volume":"51","author":"Seipelt","year":"2003","journal-title":"Thorac. Cardiovasc. Surg."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1007\/s001340050644","article-title":"Postoperative plasma concentrations of procalcitonin after different types of surgery","volume":"24","author":"Meisner","year":"1998","journal-title":"Intensive Care Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/S0009-739X(06)70890-9","article-title":"Role of plasma procalcitonin determination in the postoperative follow-up of cephalic pancreatoduodenectomy","volume":"79","author":"Bianchi","year":"2006","journal-title":"Cir. Esp."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1007\/s10571-017-0538-5","article-title":"Serum Procalcitonin Levels are Associated with Clinical Outcome in Intracerebral Hemorrhage","volume":"38","author":"He","year":"2018","journal-title":"Cell. Mol. Neurobiol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1007\/s12028-016-0337-8","article-title":"Procalcitonin is a Poor Predictor of Non-Infectious Fever in the Neurocritical Care Unit","volume":"27","author":"Halvorson","year":"2017","journal-title":"Neurocrit. Care"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/S0966-3274(98)80013-0","article-title":"Procalcitonin: A new marker for diagnosis of acute rejection and bacterial infection in patients after heart and lung transplantation","volume":"6","author":"Hammer","year":"1998","journal-title":"Transpl. Immunol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/S0967-2109(00)00070-3","article-title":"Procalcitonin (PCT) in cardiac surgery: Diagnostic value in systemic inflammatory response syndrome (SIRS), sepsis and after heart transplantation (HTX)","volume":"8","author":"Boeken","year":"2000","journal-title":"Cardiovasc. Surg."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1097\/00003246-200002000-00044","article-title":"Procalcitonin in fever of unknown origin after liver transplantation: A variable to differentiate acute rejection from infection","volume":"28","author":"Kuse","year":"2000","journal-title":"Crit. Care Med."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"e14224","DOI":"10.1111\/ctr.14224","article-title":"Serum procalcitonin as a biomarker for differentiating between infectious and non-infectious fever after pancreas transplantation","volume":"35","author":"Shim","year":"2021","journal-title":"Clin. Transplant."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"S187","DOI":"10.1007\/s001340051142","article-title":"Procalcitonin-a new diagnostic tool in complications following liver transplantation","volume":"26","author":"Kuse","year":"2000","journal-title":"Intensive Care Med."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1111\/j.1432-2277.2003.tb00334.x","article-title":"Analysis of systemic and regional procalcitonin serum levels during liver transplantation","volume":"16","author":"Fazakas","year":"2003","journal-title":"Transpl. Int."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"I192","DOI":"10.1161\/hc37t1.094836","article-title":"Procalcitonin, a donor-specific predictor of early graft failure-related mortality after heart transplantation","volume":"104","author":"Wagner","year":"2001","journal-title":"Circulation"},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Mu\u0107ka, S., Jakubiak, G.K., and Pawlas, N. (2025). Procalcitonin: Infection or Maybe Something More? Noninfectious Causes of Increased Serum Procalcitonin Concentration: Updated Knowledge. Life, 15.","DOI":"10.3390\/life15030446"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"610","DOI":"10.21037\/atm-20-1855","article-title":"A 2020 review on the role of procalcitonin in different clinical settings: An update conducted with the tools of the Evidence Based Laboratory Medicine","volume":"8","author":"Azzini","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_93","first-page":"7188","article-title":"Meta-analysis of the diagnostic value of serum procalcitonin for burn sepsis in adults","volume":"27","author":"Zhang","year":"2023","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"S77","DOI":"10.5005\/jp-journals-10071-24326","article-title":"Guidelines for the Use of Procalcitonin for Rational Use of Antibiotics","volume":"26","author":"Khilnani","year":"2022","journal-title":"Indian J. Crit. Care Med."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s13054-024-04824-3","article-title":"Procalcitonin for the diagnosis of postoperative bacterial infection after adult cardiac surgery: A systematic review and meta-analysis","volume":"28","author":"Nicolotti","year":"2024","journal-title":"Crit. Care"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s00134-021-06506-y","article-title":"Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021","volume":"47","author":"Evans","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"e220161","DOI":"10.1530\/ETJ-22-0161","article-title":"The role of procalcitonin in the follow-up of medullary thyroid cancer","volume":"12","author":"Censi","year":"2023","journal-title":"Eur. Thyroid. J."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Jeong, I.Y., Yun, H.J., Kim, S.M., and Park, Y. (2024). Diagnostic Performance of Preoperative Calcitonin and Procalcitonin Tests for Differential Diagnosis of Medullary Thyroid Cancer. Diagnostics, 14.","DOI":"10.3390\/diagnostics14161809"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"96","DOI":"10.3109\/17482941.2010.498920","article-title":"Kinetics of procalcitonin in cardiogenic shock and in septic shock. Preliminary data","volume":"12","author":"Picariello","year":"2010","journal-title":"Acute Card. Care"},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Cong, S., Ma, T., Di, X., Tian, C., Zhao, M., and Wang, K. (2021). Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: A meta-analysis. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06064-0"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s13613-018-0479-2","article-title":"Comparison of the Accuracy of Neutrophil CD64, Procalcitonin, and C-Reactive Protein for Sepsis Identification: A Systematic Review and Meta-Analysis","volume":"9","author":"Yeh","year":"2019","journal-title":"Ann. Intensive Care"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"155087","DOI":"10.1016\/j.jcrc.2025.155087","article-title":"Comparison of the Diagnostic Accuracies of Various Biomarkers and Scoring Systems for Sepsis: A Systematic Review and Bayesian Diagnostic Test Accuracy Network Meta-Analysis","volume":"88","author":"Lan","year":"2025","journal-title":"J. Crit. Care"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"105074","DOI":"10.1016\/j.meegid.2021.105074","article-title":"Diagnostic and Prognostic Predictive Values of Circulating sTREM-1 in Sepsis: A Meta-Analysis","volume":"96","author":"Qin","year":"2021","journal-title":"Infect. Genet. Evol."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Chang, W., Peng, F., Meng, S.S., Xu, J.Y., and Yang, Y. (2020). Diagnostic Value of Serum Soluble Triggering Expressed Receptor on Myeloid Cells 1 (sTREM-1) in Suspected Sepsis: A Meta-Analysis. BMC Immunol., 21.","DOI":"10.1186\/s12865-020-0332-x"},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Wu, J., Hu, L., Zhang, G., Wu, F., and He, T. (2015). Accuracy of Presepsin in Sepsis Diagnosis: A Systematic Review and Meta-Analysis. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0133057"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1186\/s13054-015-1032-4","article-title":"The Accuracy of Presepsin (sCD14-ST) for the Diagnosis of Sepsis in Adults: A Meta-Analysis","volume":"19","author":"Zhang","year":"2015","journal-title":"Crit. Care"},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Liang, J., Cai, Y., and Shao, Y. (2023). Comparison of Presepsin and Mid-Regional Pro-Adrenomedullin in the Diagnosis of Sepsis or Septic Shock: A Systematic Review and Meta-Analysis. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-08262-4"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"e14225","DOI":"10.1111\/eci.14225","article-title":"Midregional-proAdrenomedullin as a Prognostic Tool in Sepsis and Septic Shock: A Systematic Review and Meta-Analysis","volume":"54","author":"Valeriani","year":"2024","journal-title":"Eur. J. Clin. Invest."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.jinf.2017.12.003","article-title":"Usefulness of Midregional Pro-Adrenomedullin as a Marker of Organ Damage and Predictor of Mortality in Patients With Sepsis","volume":"76","author":"Vera","year":"2018","journal-title":"J. Infect."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/s13054-018-2001-5","article-title":"The Use of Mid-Regional Proadrenomedullin to Identify Disease Severity and Treatment Response to Sepsis","volume":"22","author":"Elke","year":"2018","journal-title":"Crit. Care"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1097\/SHK.0000000000001434","article-title":"The Diagnostic and Prognostic Value of suPAR in Patients With Sepsis: A Systematic Review and Meta-Analysis","volume":"53","author":"Huang","year":"2020","journal-title":"Shock"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"39481","DOI":"10.1038\/srep39481","article-title":"Serum Soluble Urokinase-Type Plasminogen Activator Receptor as a Biological Marker of Bacterial Infection in Adults: A Systematic Review and Meta-Analysis","volume":"6","author":"Ni","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1515\/cclm-2025-1299","article-title":"Prognostic Value of suPAR in Sepsis: A Potential Tool to Support Patient Management in the Emergency Department","volume":"64","author":"Leggeri","year":"2025","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Sri-On, J., Daorattanachai, K., Wiwatcharagoses, K., Phungoen, P., Isaranuwatchai, S., Sanguanwit, P., Piyasuwankul, T., Bunchit, W., Sinsuwan, N., and Rojsaengroeng, R. (2026). Presepsin for Sepsis Diagnosis in Emergency Departments: A Multicentre Study. Emerg. Med. J., ahead of print.","DOI":"10.1136\/emermed-2025-215345"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1007\/s00134-012-2613-1","article-title":"Usefulness of suPAR as a Biological Marker in Patients With Systemic Inflammation or Infection: A Systematic Review","volume":"38","author":"Backes","year":"2012","journal-title":"Intensive Care Med."},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Ljungstr\u00f6m, L., Pernestig, A.K., Jacobsson, G., Andersson, R., Usener, B., and Tilevik, D. (2017). Diagnostic Accuracy of Procalcitonin, Neutrophil-Lymphocyte Count Ratio, C-Reactive Protein, and Lactate in Patients With Suspected Bacterial Sepsis. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0181704"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1164\/rccm.201201-0037OC","article-title":"Combination Biomarkers to Diagnose Sepsis in the Critically Ill Patient","volume":"186","author":"Gibot","year":"2012","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.diagmicrobio.2015.10.003","article-title":"Diagnostic Accuracy and Clinical Relevance of an Inflammatory Biomarker Panel for Sepsis in Adult Critically Ill Patients","volume":"84","author":"Bauer","year":"2016","journal-title":"Diagn. Microbiol. Infect. Dis."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/3\/464\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T05:26:45Z","timestamp":1772688405000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/3\/464"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,28]]},"references-count":118,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["medicina62030464"],"URL":"https:\/\/doi.org\/10.3390\/medicina62030464","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,28]]}}}