The Potential Role of Procalcitonin Compared to C-reactive protein and Neutrophil Lymphocyte Ratio in Prediction of Severity and Outcomes of Acute Corrosive Ingestion

Document Type : Original Article


Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University Hospitals, Cairo, Egypt.


Background: Caustic ingestion in children is considered a serious healthcare issue worldwide
due to its high morbidity and mortality rates. Aim: The present study aimed to evaluate the
potential role of procalcitonin (PCT) compared to C-reactive protein (CRP) and neutrophil
lymphocyte ratio (NLR) in assessment of severity and prediction of outcomes of acute corrosive
ingestion for early intervention and better prognosis. Methods: This prospective study was
conducted on 60 patients aged from 6 months to 12 years, who were admitted to poison control
center, Ain Shams University Hospitals with diagnosis of acute caustic ingestion. Demographic, clinical data and blood samples were collected from each patient, with biomarkers’ assessment
within 24 hours post caustic ingestion. Results: The majority of patients were males (70%) with
median age 1.5 years. Acute and/or chronic complications occurred in 43.3% of the studied
patients. Significantly higher levels of PCT, CRP and NLR were detected in complicated
patients, as well patients with DROOL score ≤4. Procalcitonin level <1.4 ng/mL was the most
specific biomarker (94.12%) with the highest positive predictive value (90.5%) in predicting
complications occurrence, whereas CRP level <9.6 mg/L was the most sensitive biomarker
(100%). Conclusion: This study supports the role of PCT, CRP and NLR as reliable biomarkers
in early predicting the severity and outcomes of corrosive ingestion in children. PCT seemed to
be superior to CRP and NLR in predicting complications post caustic ingestion