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CRP levels in autoimmune disease can be specified by measurement of procalcitonin

  • Clinical and Epidemiological Studies
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Summary

Autoimmune diseases (AID) are prone to infection particularly under immunosuppression. The differentiation of infection from active AID is often difficult. In order to specify the diagnostic value of measurement of procalcitonin (PCT) in AID 81 patients with anti-neutrophil cytoplasmic antibody (ANCA)-positive vasculitis were analyzed, 27 with rheumatoid arthritis and 25 patients with systemic lupus erythematosus at various stages of the disease. Although PCT levels (95th percentile) were below 0.5 ng/ml in patients with active systemic lupus erythematosus and rheumatoid arthritis, the cutoff for normal values (95th percentile) in patients with active ANCA-positive vasculitis was 0.89. Therefore PCT levels of <1 ng/ml are recommended as cutoff for invasive infections in patients with ANCA-positive vasculitis. In view of the increased mortality under immunosuppression in patients with AID and additional bacterial infection the measurement of PCT is helpful when an infectious origin is suspected.

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References

  1. Assicot, M., Gendrel, D., Carsin, H., Rymoand, J., Guibaud, J., Rohuon, C.: High serum procalcitonin concentrations in patients with sepsis and infection. Lancet 341 (1993) 515–518.

    Article  PubMed  CAS  Google Scholar 

  2. Gendrel, D., Bohuon, C.: Procalcitonin, a marker of bacterial infection. Infection 25 (1997) 133–134.

    Article  PubMed  CAS  Google Scholar 

  3. Karazai, W., Oberhoffer, M., Meier-Hellmann, A., Reinhart, K.: Procalcitonin-a new indicator of the systemic response to severe infections. Infection 25 (1997) 329–333.

    Article  Google Scholar 

  4. Bradley, J. D., Brandt, K. D., Katz, B.: Infectious complications of cyclophosphamide treatment for vasculitis. Arthritis Rheum. 32 (1989) 45–53.

    Article  PubMed  CAS  Google Scholar 

  5. Neild, G. H.: Infectious complications in the management of systemic vasculitis and rapidly progressive glomerulonephritis. APMIS Suppl. 98 (1990) 56–60.

    Google Scholar 

  6. Eberhard, O. K., Haubitz, M., Brunkhorst, F. M., Kliem, V., Koch, K. M., Brunkhorst, R.: Usefulness of procalcitonin for differentiation between activity of systemic autoimmune disease (systemic lupus erythematousus/systemic antineutrophil cytoplasmatic antibody-associated vasculitis) and invasive bacterial infection. Arthritis Rheum. 40 (1997) 1250–1256.

    PubMed  CAS  Google Scholar 

  7. Jennette, J. C., Falk, R. J., Andrassy, K., Bacon, B., Churg, J., Gross, W. L., Hagen, C., Hoffman, G. S., Hunder, G. G., Kallenberg, C. G. M., McCluskey, R. T., Sinico, R. A., Rees, A. J., vanEs, L. A., Waldherr, R., Wiik, A.: Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum 37 (1994) 187–192.

    Article  PubMed  CAS  Google Scholar 

  8. Luqmani, R. A., Bacon, P. A., Moots, R. J., Janssen, B. A., Pall, A., Emery, P., Savage, C., Adu, D.: Birmingham vasculitis activity score (BVAS) in systemic necrotizing vasculitis. Quart. J. Med. 87, (1994) 671–678.

    CAS  Google Scholar 

  9. Bombardier, C., Gladman, D. D., Urowitz, M. B., Caron, D., Chang, C. H., and theCommittee on Prognosis Studies in SLE: Derivation of the Sledai. A disease activity index for lupus patients. Arthritis Rheum. 35 (1992) 630–640.

    Article  PubMed  CAS  Google Scholar 

  10. Arnett, F. C., Edworthy, S. M., Bloch, D. A., McShane, D. J., Fries, J. F., Cooper, N. S., Healey, L. A., Kaplan, S. R., Liang, M. H., Luthra, H. S., Medsger, T. A., Mitchell, D. M., Neustadt, D. H., Pinals, R. S., Schaller, J. G., Sharp, J. T., Wider, R. L., Hunder, G. G.: The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 31 (1988) 315–324.

    Article  PubMed  CAS  Google Scholar 

  11. Pepsy, M. B.: C-reactive protein fifty years on. Lancet i (1981) 653–657.

    Article  Google Scholar 

  12. Dandona, P., Nix, D., Wilson, M. F., Aljada, A., Love, J., Assicot, M., Bohuon, C.: Procalcitonin increase after endotoxin injection in normal subjects. J. Clin. Endocrinol. Metabol. 79 (1994) 1605–1608.

    Article  CAS  Google Scholar 

  13. Meisner, M., Tschaikowsky, K., Schmidt, J., Schüttler, J.: Procalcitonin-indications for a new diagnostic parameter of severe bacterial infection and sepsis in transplantation, immunosuppression and cardiac assist devices. Cardiovascular Engineering 1 (1996) 67–76.

    Google Scholar 

  14. Weidemann, S., Andrassy, K., Ritz, E.: ANCA in haemodialysis patients. Nephrol. Dial. Transplant. 8 (1993) 839–845.

    CAS  Google Scholar 

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Schwenger, V., Sis, J., Breitbart, A. et al. CRP levels in autoimmune disease can be specified by measurement of procalcitonin. Infection 26, 274–276 (1998). https://doi.org/10.1007/BF02962246

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  • DOI: https://doi.org/10.1007/BF02962246

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