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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

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CiteScore 2018: 2.44

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Volume 57, Issue 10


Utility of procalcitonin for differentiating cryptogenic organising pneumonia from community-acquired pneumonia

Akihiro Ito
  • Corresponding author
  • Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Miwa, Kurashiki 710-8602, Japan, Phone: +81 86 422 0210, Fax: +81 86 421 3424
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/ Tadashi Ishida
  • Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Kurashiki, Japan
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/ Hiromasa Tachibana
  • Department of Respiratory Medicine, National Hospital Organization, Minami Kyoto Hospital, Joyo, Japan
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  • De Gruyter OnlineGoogle Scholar
/ Machiko Arita
  • Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Kurashiki, Japan
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/ Akio Yamazaki / Yasuyoshi Washio
  • Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2019-05-23 | DOI: https://doi.org/10.1515/cclm-2019-0175



This study aimed to investigate the usefulness of inflammatory biomarkers such as white blood cell (WBC) count, C-reactive protein (CRP) and procalcitonin (PCT) for differentiating cryptogenic organising pneumonia (COP) from community-acquired pneumonia (CAP).


COP patients hospitalised in Kurashiki Central Hospital between January 2010 and December 2017 whose WBC counts and CRP and PCT levels were measured were investigated retrospectively, and their results were compared with those of hospitalised CAP patients who were prospectively enrolled between October 2010 and November 2017. Definite COP was defined by specific histopathological findings, and possible COP was defined as a consolidation shadow on chest computed tomography and lymphocyte dominance in bronchoalveolar lavage fluid in the absence of specific histopathological findings or lung specimens. The discriminatory abilities of WBC counts, CRP and PCT were evaluated by receiver operating characteristic (ROC) curve analysis.


There were 56 patients in the entire COP group, 35 (61.4%) with definite COP, and 914 CAP patients. All three biomarkers were significantly lower in COP than in CAP. The AUC value of PCT in all COP patients was 0.79, significantly higher than of both CRP (AUC 0.59, p < 0.001) and WBC (AUC 0.69, p = 0.048). In definite COP patients, the AUC value of PCT was 0.79, which was also significantly higher than of both WBC (AUC 0.64, p = 0.006) and CRP (AUC 0.64, p = 0.001).


PCT is a more useful biomarker for differentiating COP from CAP than WBC count or CRP. However, PCT should be used as an adjunct to clinical presentation and radiological findings.

Keywords: C-reactive protein; community-acquired pneumonia; cryptogenic organising pneumonia; inflammatory biomarker; procalcitonin


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About the article

Received: 2019-02-13

Accepted: 2019-04-23

Published Online: 2019-05-23

Published in Print: 2019-09-25

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organisation(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 57, Issue 10, Pages 1632–1637, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2019-0175.

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