Takajo Ichiro, Yamamoto Ikuo, Umeki Kazumi, Okayama Akihiko
Department of Rheumatology, Infectious Diseases and Laboratory Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.
Rinsho Byori. 2012 Apr;60(4):294-9.
Procalcitonin (PCT), a precursor for calcitonin, has been reported to be elevated in bacterial infection. However, its significance in the diagnosis of bacterial infection in patients with systemic autoimmune diseases, who have treatment with corticosteroid and immunosuppressive drug, is limited. To investigate the usefulness of serum procalcitonin measurement in the diagnosis of bacterial infection in patients with systemic autoimmune diseases, we analyzed 28 patients with systemic autoimmune diseases hospitalized because of fever and/or C-reactive protein (CRP) elevation. PCT was measured by the immunochromatography assay. Fourteen patients were considered having bacterial infections and the other 14 patients were considered having disease flare of their systemic autoimmune diseases. Serum CRP levels in the bacterial infection group was higher than that in the systemic autoimmune disease flare group; however, the difference did not reach statistical significance. The positive rate of serum PCT was significantly higher in the bacterial infection group (10/14, 71%) than that in the systemic autoimmune disease flare group (1/14, 7%), although there were 2 cases showing false positive PCT probably due to rheumatoid factor. This study suggested that PCT is useful in the diagnosis of bacterial infection in patients with systemic autoimmune diseases who are treated with corticosteroid and immunosuppressive drug.
降钙素原(PCT)是降钙素的前体,据报道在细菌感染时会升高。然而,其在接受皮质类固醇和免疫抑制药物治疗的全身性自身免疫性疾病患者细菌感染诊断中的意义有限。为了研究血清降钙素原检测在全身性自身免疫性疾病患者细菌感染诊断中的实用性,我们分析了28例因发热和/或C反应蛋白(CRP)升高而住院的全身性自身免疫性疾病患者。采用免疫层析法检测PCT。14例患者被认为患有细菌感染,另外14例患者被认为是全身性自身免疫性疾病病情复发。细菌感染组的血清CRP水平高于全身性自身免疫性疾病病情复发组;然而,差异未达到统计学意义。细菌感染组血清PCT阳性率(10/14,71%)显著高于全身性自身免疫性疾病病情复发组(1/14,7%),尽管有2例可能由于类风湿因子导致PCT假阳性。本研究表明,PCT对接受皮质类固醇和免疫抑制药物治疗的全身性自身免疫性疾病患者细菌感染的诊断有用。