Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Usefulness of Procalcitonin Measurement in Differentiating between Activity of Systemic Autoimmune Disease and Bacterial Infection.

Sleglova3,  Olga, Dejmkova4,  Helena, Uhrova2,  Jana, Belacek1,  Jaromir

Department of Biostatistics, 1. Medical Faculty, Charles University, Prague, Czech Republic
Institute of Clinical Biochemistry, Prague, Czech Republic, Czech Republic
Institute of Rheumatology, Prague, Czech Republic
Institute of Rheumatology, Prague, Czech Republic

Objective:

To evaluate the usefulness of testing for serum procalcitonin (PCT) in the differential diagnosis of infectious complications and acute disease exacerbation in patients with systemic autoimmune diseases.

Methods:

125 patients with systemic autoimmune diseases who were admitted to the inpatient department for suspected acute infection or acute exacerbation of their disease were prospectively tested for PCT concentrations. Concurrently, the levels of C-reactive protein (CRP), white blood cell counts (WBC), C3 and C4 complement components were established. The group of patients with infection comprised of two subgroups: with systemic and localised infection. Control group included 87 ambulatory patients with autoimmune diseases without any signs of deterioration.

Results:

The serum PCT levels were significantly higher in patients with infections than in patients with an active systemic disease (PCT mean ± SEM 4.560 ± 1,513 vs. 0,254 ± 0,029, p< 0,001). The levels of CRP and white blood cell counts were also higher in patients with infections; the differences between C3 and C4 complement component values were not statistically significant. PCT serum concentrations were not elevated in any of the patients included in control group, and they were not affected by the current corticosteroids or immunosuppressive treatment. The sensitivity of the PCT test for an infectious complication (cut-off value = 0.5ng/ml) was 52.4%, specificity 94.0% and diagnostic accuracy 80.2%. The area under ROC curve for PCT was 73.21%.

Conclusion:

The increased serum PCT levels demonstrate good specificity for the evidence of infection in patients with systemic diseases. The sensitivity of PCT serum values is lower and it is therefore suitable to complement the assessment with another high-sensitivity indicator, such as CRP.

This report was supported by Czech grant IGA MZ CR NR/929 1–3.

To cite this abstract, please use the following information:
Sleglova, Olga, Dejmkova, Helena, Uhrova, Jana, Belacek, Jaromir; Usefulness of Procalcitonin Measurement in Differentiating between Activity of Systemic Autoimmune Disease and Bacterial Infection. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1649
DOI: 10.1002/art.29414

Abstract Supplement

Meeting Menu

2010 ACR/ARHP