European Journal of Pediatrics

, Volume 177, Issue 9, pp 1377–1381 | Cite as

Use of procalcitonin in the diagnosis of tuberculosis in infants and preschool children

  • Eneritz Velasco-Arnaiz
  • Esther Pérez
  • Desirée Henares
  • Anna Fernández-López
  • Anna Valls
  • Pedro Brotons
  • Clàudia Fortuny
  • Antoni Noguera-JulianEmail author
Short Communication


Normal procalcitonin (PCT) levels have been reported in adult pulmonary tuberculosis (TB) but have not been previously investigated in children. We aimed to assess PCT levels at diagnosis of TB in young children in a low-burden setting. In a cross-sectional observational study in a referral pediatric center in Barcelona (Spain), we assessed the value of PCT and other inflammatory markers (leucocyte counts, C-reactive protein, and erythrocyte sedimentation rate) in the diagnosis of TB in pre-school children (< 6 years at diagnosis, n = 45), as compared with two control groups (pneumococcal pneumonia, n = 25; and healthy controls, n = 49). Normal PCT levels were observed at diagnosis of TB in most cases, while C-reactive protein values and leucocyte counts were slightly elevated when compared to healthy controls. All three inflammatory biomarkers were significantly higher in children with pneumococcal pneumonia.

Conclusions: In our study, PCT was not a useful diagnostic test for TB in young children. In a low-burden TB setting, PCT may be of some value in distinguishing pulmonary TB from pneumococcal pneumonia.

What is Known:

Diagnosis of pediatric tuberculosis on clinical evidence is difficult, particularly in infants and small children.

Studies in adults with tuberculosis have mostly reported normal procalcitonin levels at diagnosis.

What is New:

In pre-scholars with tuberculosis, erythrocyte sedimentation rate and white blood cell counts were higher than in healthy controls, but procalcitonin was not.

Procalcitonin may be useful in the differential diagnosis of intrathoracic tuberculosis and pneumococcal pneumonia.


C-reactive protein Erythrocyte sedimentation rate Pneumonia Procalcitonin Tuberculosis 



Bacillus Calmette-Guérin


Community-acquired pneumonia


C-reactive protein


Erythrocyte sedimentation rate




Interquartile range


Mycobacterium tuberculosis




QuantiFERON-TB Gold In-Tube


Tuberculin skin test




White blood cell



We are indebted to the “Biobanc de l’Hospital Infantil Sant Joan de Déu per a la Investigació,” a member of the ISCIII National Network of Biobanks, for sample and data procurement.

Authors’ contributions

EVA, EP, CF, and ANJ designed the study. DH, AV, and PB developed the methodology. EVA, EP, DH, AFL, and CF collected the data. EVA and ANJ performed the analysis and wrote the first draft of the manuscript. All authors saw, approved, and take full responsibility for the final version of the manuscript.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent for publication

Informed consent was obtained from all individual participants included in the study.

Supplementary material

431_2018_3099_MOESM1_ESM.docx (16 kb)
Table 2 (DOCX 15 kb)
431_2018_3099_MOESM2_ESM.docx (18 kb)
Table 3 (DOCX 17 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Eneritz Velasco-Arnaiz
    • 1
  • Esther Pérez
    • 1
  • Desirée Henares
    • 2
  • Anna Fernández-López
    • 1
  • Anna Valls
    • 3
  • Pedro Brotons
    • 2
    • 4
  • Clàudia Fortuny
    • 1
    • 4
    • 5
    • 6
  • Antoni Noguera-Julian
    • 1
    • 4
    • 5
    • 6
    Email author
  1. 1.Malalties infeccioses i resposta inflamatòria sistèmica en pediatria, Unitat d’Infeccions, Servei de PediatriaInstitut de Recerca Pediàtrica Hospital Sant Joan de DéuEspluguesSpain
  2. 2.Institut de Recerca PediàtricaHospital Sant Joan de DéuEspluguesSpain
  3. 3.Laboratory DepartmentHospital Sant Joan de DéuEspluguesSpain
  4. 4.CIBER de Epidemiología y Salud Pública (Ciberesp)Santa Cruz de TenerifeSpain
  5. 5.Departament de PediatriaUniversitat de BarcelonaEspluguesSpain
  6. 6.Traslational Research Network in Pediatric Infectious Diseases (RITIP)MadridSpain

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