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Serum procalcitonin does not differentiate between infection and disease flare in patients with systemic lupus erythematosus.
MedLine Citation:
PMID:  20937623     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Systemic erythematosus lupus (SLE) is a common autoimmune disease. Disease flares may mimic infection with fever, inflammatory syndrome and chills, sometimes resulting in a difficult differential diagnosis. Elevated serum procalcitonin (PCT) levels have been reported to be predictive of bacterial infections, but with conflicting results. The value of serum procalcitonin has not been assessed in large series of SLE. We aimed to describe the distribution of PCT levels in SLE patients with and without flares, to assess the factors associated with increased PCT levels, and to determine the positive and negative predictive values of increased PCT for bacterial infection in SLE patients. Hospitalized SLE patients were included in a retrospective study. Serum PCT had been assayed, or a serum sample had been frozen on admission, before treatment modification. Serum PCT, measured by an automated immunofluorometric assay, and SLEDAI were assessed at the same time. Some 53 women (median age: 33.7 years, range 16-76) and seven men (median age: 52.5 years ± 19) were included. The median SLEDAI for patients with flare (n = 16, 28%) was 2 (range: 0-29). Five patients (8%) had systemic infection. Only one patient had increased PCT levels. Men had significantly higher PCT levels than women (0.196 ± 0.23 versus 0.066 ± 0.03, p < 0.01) and a significant correlation was observed between PCT, age, erythrocyte sedimentation rate, and C-reactive protein. We conclude that PCT levels were within the normal range in infected and non-infected SLE patients and there was no ability to differentiate SLE patients with or without bacterial infection.
Authors:
Jp Lanoix; Am Bourgeois; J Schmidt; J Desblache; V Salle; A Smail; Jc Mazière; F Betsou; G Choukroun; P Duhaut; Jp Ducroix
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Publication Detail:
Type:  Journal Article     Date:  2010-10-11
Journal Detail:
Title:  Lupus     Volume:  20     ISSN:  1477-0962     ISO Abbreviation:  Lupus     Publication Date:  2011  
Date Detail:
Created Date:  2011-02-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204265     Medline TA:  Lupus     Country:  England    
Other Details:
Languages:  eng     Pagination:  125-30     Citation Subset:  IM    
Affiliation:
1Department of Internal Medicine and RECIF. Amiens University Hospital, Place Victor Pauchet, 80000 Amiens, France.
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