PT  - JOURNAL ARTICLE
AU  - HYOUN-AH KIM
AU  - JA-YOUNG JEON
AU  - JEONG-MI AN
AU  - BO-RAM KOH
AU  - CHANG-HEE SUH
TI  - C-reactive Protein Is a More Sensitive and Specific Marker for Diagnosing Bacterial Infections in Systemic Lupus Erythematosus Compared to S100A8/A9 and Procalcitonin
AID  - 10.3899/jrheum.111044
DP  - 2012 Apr 01
TA  - The Journal of Rheumatology
PG  - 728--734
VI  - 39
IP  - 4
4099  - http://www.jrheum.org/content/39/4/728.short
4100  - http://www.jrheum.org/content/39/4/728.full
SO  - J Rheumatol2012 Apr 01; 39
AB  - Objective. C-reactive protein (CRP), S100A8/A9, and procalcitonin have been suggested as markers of infection in patients with systemic lupus erythematosus (SLE). We investigated the clinical significance of these factors for indication of infection in SLE. Methods. Blood samples were prospectively collected from 34 patients with SLE who had bacterial infections and 39 patients with SLE who had disease flares and no evidence of infection. A second set of serum samples was collected after the infections or flares were resolved. Results. CRP levels of SLE patients with infections were higher than those with flares [5.9 mg/dl (IQR 2.42, 10.53) vs 0.06 mg/dl (IQR 0.03, 0.15), p < 0.001] and decreased after the infection was resolved. S100A8/A9 and procalcitonin levels of SLE patients with infection were also higher [4.69 μg/ml (IQR 2.25, 12.07) vs 1.07 (IQR 0.49, 3.05) (p < 0.001) and 0 ng/ml (IQR 0–0.38) vs 0 (0–0) (p < 0.001), respectively]; these levels were also reduced once the infection disappeared. In the receiver-operating characteristics analysis of CRP, S100A8/A9, and procalcitonin, the area under the curve was 0.966 (95% CI 0.925–1.007), 0.732 (95% CI 0.61–0.854), and 0.667 (95% CI 0.534–0.799), respectively. CRP indicated the presence of an infection with a sensitivity of 100% and a specificity of 90%, with a cutoff value of 1.35 mg/dl. Conclusion. Our data suggest that CRP is the most sensitive and specific marker for diagnosing bacterial infections in SLE.