BACKGROUND: High plasma levels of procalcitonin (PCT) are typically seen in children with severe bacterial infection, particularly in cases of septic shock or bacteremia. Similarly, pancreatic stone protein (PSP) is associated with inflammation, infection, and other disease-related stimuli. However, the prognostic value of PSP in critically ill pediatric patients is unknown. This study investigated the early diagnostic value of PCT and PSP in pediatric acute osteomyelitis.

MATERIAL AND METHODS: A total of 187 patients with suspected acute osteomyelitis and 80 healthy control children were enrolled. The serum expression of PTC and PSP was measured. Pearson correlation analysis was conducted to correlate PTC with PSP. ROC analysis was used to test the value of PTC and PSP in early diagnosis of pediatric acute osteomyelitis.

RESULTS: Acute osteomyelitis was diagnosed in 49.2% of the patients (n=92) based on the layered bone puncture. The serum levels of PTC and PSP in pediatric acute osteomyelitis were higher than in the non-acute osteomyelitis group (P<0.01). Serum PTC concentrations showed a significantly positive correlation with PSP levels (P<0.001). ROC analysis showed that the AUC values of PTC and PSP were 0.767 (95% CI, 0.700–0.826), and 0.796 (95% CI, 0.731–0.855), respectively. The AUC value of PTC & PSP was 0.903 (95% CI: 0.851–0.941), which was markedly increased compared with PTC or PSP (P<0.01).

CONCLUSIONS: Serum levels of PCT and PSP are promising biomarkers for early diagnosis of pediatric acute osteomyelitis.

Keywords: Calcitonin, Diagnosis, Lithostathine, osteomyelitis