THE ASSOCIATION OF PROCALCITONIN, LACTATE, WBC COUNT, AND INTERLEUKIN-10 MAY BE HELPFUL IN THE EARLY DIAGNOSIS OF SEPSIS IN BRAZILIAN PATIENTS

Autores

DOI:

https://doi.org/10.25110/arqsaude.v29i3.2025-12124

Palavras-chave:

Procalcitonin, Interleukin-10, Interleukin-6, Sepsis

Resumo

Introduction: Sepsis is a set of clinical symptoms resulting from inflammation and infection. Several biomarkers are used for early diagnosis and improved management of sepsis. Objectives: This study evaluated the performance of procalcitonin (PCT), interleukin-10 (IL-10), interleukin-6 (IL-6), and classic inflammatory markers in hospitalized patients with suspected sepsis. Sixty-one patients were assessed. The participants were monitored over a three-day period: baseline (Day 0, D0), 24 hours (Day 1, D1), and 48 hours (Day 2, D2). The hospital’s clinical team classified them as “sepsis” or “non-sepsis”. Results: On the first day (D0), PCT, lactate, leukocyte count, IL-10, and IL-6 were elevated in patients with sepsis compared to those without. On Day 1, all of these biomarkers remained elevated in the sepsis group except for IL-6. By Day 2, none of the parameters differed between the sepsis and non-sepsis groups. AUC analyses demonstrated that PCT, lactate, leukocyte count, and IL-10 could discriminate between sepsis and non-sepsis patients, with IL-10 showing the best sensitivity and specificity at D0 and D1. Conclusion: When combined, the biomarkers performed better in diagnosing sepsis in the Brazilian population.

Downloads

Não há dados estatísticos.

Biografia do Autor

Cristiane Alves da Silva Menezes, Universidade Federal de Minas Gerais

Doutorado, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.

Victor Hugo Ferreira Gomes, Universidade Federal de Minas Gerais

Acadêmico do curso de Farmácia da Universidade Federal de Minas Gerais.

Fernanda Rocha de Freitas, Universidade Federal de Minas Gerais

Metre, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.

Simone Martins Gonçalves, Hospital Madre Tereza

Mestre, Laboratório de Patologia Clínica, Hospital Madre Tereza, Belo Horizonte, MG, Brasil.

Pâmela Santos Azevedo, Universidade Federal de Minas Gerais

Mestre, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.

Edna Afonso Reis, Universidade Federal de Minas Gerais

Doutorado, Departamento de Estatística, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.

Ieda de Fátima Oliveira Silva, Universidade Federal de Minas Gerais

Doutorado, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.

Ana Paula Lucas Mota, Universidade Federal de Minas Gerais

Doutorado, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.

Referências

ACKERMAN, M. H. et al. Sepsis. Crit Care Nurs Clin North Am, Filadélfia, v. 33, n. 4, p. 407-418, dez. 2021. DOI: 10.1016/j.cnc.2021.08.003.

ALI, W. A. et al. A randomized trial to compare procalcitonin and C-reactive protein in assessing the severity of sepsis and in guiding antibacterial therapy in Egyptian critically ill patients. Ir J Med Sci, Dublin, v. 190, n. 4, p. 1487-1495, nov. 2021.

ALMEIDA, N. R. C. et al. Analysis of trends in sepsis mortality in Brazil and by regions from 2010 to 2019. Rev Saude Publica, São Paulo, v. 56, p. 25, 22 abr. 2022.

ANGELETTI, S. et al. Procalcitonin, MR-Proadrenomedullin, and Cytokines Measurement in Sepsis Diagnosis: Advantages from Test Combination. Dis Markers, Amsterdã, 2015:951532, 2015.

DIAMENT, D. et al. Guidelines for the treatment of severe sepsis and septic shock - management of the infectious agent - diagnosis. Rev Bras Ter Intensiva, São Paulo, v. 23, n. 2, p. 134-144, jun. 2011.

FAILLA, K. R.; CONNELLY, C. D. Systematic review of gender differences in sepsis management and outcomes. J Nurs Scholarsh, Indianápolis, v. 49, n. 3, p. 312-324, 2017.

FENG, L. et al. The performance of a combination of heparin-binding protein with other biomarkers for sepsis diagnosis: an observational cohort study. BMC Infect Dis, Londres, v. 24, n. 1, p. 755, 30 jul. 2024. DOI: 10.1186/s12879-024-09666-6.

GOTTS, E. J.; MATTAY, A. M. Sepsis: pathophysiology and clinical management. BMJ, Londres, v. 353, i. 1585, 2016.

HEREDIA-RODRÍGUEZ, M. et al. Procalcitonin and white blood cells, combined predictors of infection in cardiac surgery patients. J Surg Res, Nova York, v. 212, p. 187-194, 15 maio 2017.

ILAS. Instituto Latino Americano de Sepse. [2017]. Disponível em: www.ilas.org.br.

KARON, B. S. et al. Evaluation of Lactate, white blood cell count, neutrophil count, procalcitonin and immature granulocyte count as biomarkers for sepsis in emergency department patients. Clin Biochem, Toronto, 2017.

KLEIN, M. et al. Challenging the Interpretation of White Blood Cell Counts in Patients with Sepsis Following Packed Cell Transfusion. J Clin Med, Basileia, v. 12, n. 12, p. 3912, 8 jun. 2023.

LIU, Z. et al. Prognostic accuracy of the serum lactate level, the SOFA score, and the qSOFA score for mortality among adults with sepsis. Scand J Trauma Resusc Emerg Med, Londres, v. 27, n. 1, p. 51, 2019.

MCELVANEY, O. J. et al. Interleukin-6: Obstacles to targeting a complex cytokine in critical illness. Lancet Respir Med, Londres, v. 9, n. 6, p. 643-654, jun. 2021.

MOURA, J. M. et al. Diagnóstico de sepse em pacientes após internação em unidade de terapia intensiva. Arq Cienc Saude, São José do Rio Preto, v. 24, n. 3, p. 55-60, 2017.

NOBRE, V. et al. Use of reactive hyperemia - peripheral arterial tonometry and circulating biological markers to predict outcomes in sepsis. Rev Bras Ter Intensiva, São Paulo, v. 28, n. 4, p. 387-396, out./dez. 2016.

PENG, Y. et al. The association of serum IL-10 levels with the disease activity in systemic-onset juvenile idiopathic arthritis patients. Mediators Inflamm, Nova York, 2021:6650928, 2021.

PÓVOA, P. et al. How to use biomarkers of infection or sepsis at the bedside: guide to clinicians. Intensive Care Med, Berlim, v. 49, n. 2, p. 142-153, fev. 2023.

SILVA, E. P. D. et al. Survival analysis of patients with sepsis in Brazil. Rev Soc Bras Med Trop, Uberaba, v. 52, e20180121, 11 abr. 2019.

SINGER, A. J. et al. Diagnostic characteristics of a clinical screening tool in combination with measuring bedside lactate level in emergency department patients with suspected sepsis. Acad Emerg Med, Hoboken, v. 21, n. 8, p. 853-857, ago. 2014.

SINGER, M. et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, Chicago, v. 315, n. 8, p. 801-810, 2016.

SONG, J. et al. Diagnostic and prognostic value of interleukin-6, pentraxin 3, and procalcitonin levels among sepsis and septic shock patients: a prospective controlled study according to the Sepsis-3 definitions. BMC Infect Dis, Londres, v. 19, n. 1, p. 968, 12 nov. 2019.

SRZIĆ, I.; NESEK ADAM, V.; TUNJIĆ PEJAK, D. Sepsis definition: what's new in the treatment guidelines. Acta Clin Croat, Zagreb, v. 61, n. Suppl 1, p. 67-72, jun. 2022.

TAEB, A. M.; HOOPER, M. H.; MARIK, P. E. Sepsis: Current Definition, Pathophysiology, Diagnosis and Management. Nutr Clin Pract, Thousand Oaks, v. 32, n. 3, p. 296-308, 2017.

VAN SNICK, J. Interleukin-6: an overview. Annu Rev Immunol, Palo Alto, v. 8, p. 253–278, 1990.

VINCENT, J. L. et al. Prevalence and Outcomes of Infection Among Patients in Intensive Care Units in 2017. JAMA, Chicago, v. 323, n. 15, p. 1478-1487, 21 abr. 2020.

VINCENT, J. L.; BAKKER, J. Blood lactate levels in sepsis: in 8 questions. Curr Opin Crit Care, Filadélfia, v. 27, n. 3, p. 298-302, 1 jun. 2021.

WANG, Q. Y.; LU, F.; LI, A. M. The clinical value of high mobility group box-1 and CRP/Alb ratio in the diagnosis and evaluation of sepsis in children. Eur Rev Med Pharmacol Sci, Lecce, v. 26, n. 17, p. 6361-6366, set. 2022.

WORLD HEALTH ORGANIZATION. WHO calls for global action against sepsis [Internet]. 2020. Disponível em: https://www.paho.org/pt/noticias/9-9-2020-oms-pede-acao-global-contra-sepse-causa-uma-em-cada-cinco-mortes-no-mundo.

ZENG, G. et al. Combination of C-reactive protein, procalcitonin, IL-6, IL-8, and IL-10 for early diagnosis of hyperinflammatory state and organ dysfunction in pediatric sepsis. J Clin Lab Anal, Hoboken, v. 36, n. 7, e24505, jul. 2022.

Downloads

Publicado

10-10-2025

Como Citar

MENEZES, Cristiane Alves da Silva; GOMES, Victor Hugo Ferreira; FREITAS, Fernanda Rocha de; GONÇALVES, Simone Martins; AZEVEDO, Pâmela Santos; REIS, Edna Afonso; SILVA, Ieda de Fátima Oliveira; MOTA, Ana Paula Lucas. THE ASSOCIATION OF PROCALCITONIN, LACTATE, WBC COUNT, AND INTERLEUKIN-10 MAY BE HELPFUL IN THE EARLY DIAGNOSIS OF SEPSIS IN BRAZILIAN PATIENTS. Arquivos de Ciências da Saúde da UNIPAR, [S. l.], v. 29, n. 3, p. 1231–1248, 2025. DOI: 10.25110/arqsaude.v29i3.2025-12124. Disponível em: https://www.revistas.unipar.br/index.php/saude/article/view/12124. Acesso em: 5 dez. 2025.

Edição

Seção

Artigos