Serum procalcitonin has negative predictive value for bacterial infection in active systemic lupus erythematosus

Bador, Khalidah Mazlan; Intan, S Ismail; Hussin, Supyan; Gafor, Abdul Halim Abdul

doi:10.1177/0961203312450085

Cited by 36 publications

(26 citation statements)

References 21 publications

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“…In contrast to previous data, demonstrating no diagnostic value for bacterial infection in AID patients [ 7 , 8 ], but in line with other reports [ 9 , 10 ], we detected the utility of PCT for differentiating between bacterial infection and nonbacterial condition. The ambiguous conclusions may be attributable to several factors: First, enrolled difference kind of AID or heterogeneous groups of patients as controls.…”

Section: Discussionsupporting

confidence: 88%

The utility of initial procalcitonin and procalcitonin clearance for prediction of bacterial infection and outcome in critically ill patients with autoimmune diseases: a prospective observational study

Shi

Jiang

et al. 2015

BMC Anesthesiol

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BackgroundThe diagnostic value of procalcitonin (PCT) for patients with autoimmune diseases (AID) remains controversial and few studies focused on ICU patients. We sought to determine its diagnostic and prognostic values in this clowd.MethodsA prospective observational study was conducted in AID patients admitted to the ICU. Serum PCT levels were measured on ICU admission and subsequently at days 1, 3, 5 and 7, and peak PCT levels within 24 h (PCTpeak) were analyzed the utility for bacterial infection. The relationship of PCTpeak and SOFA score and severity of sepsis was performed correlation analysis. The change of PCT over time reflected as PCT clearance was compared to ICU 28-day mortality.ResultsOne hundred twelve patients were divided into bacterial infection group (group I, n = 54) and nonbacterial condition group (group II, n = 58). The median PCTpeak (range, μg/L) was higher in the group I than that in the group II (1.95 [0.38–37.56] vs. 0.64 [0.05–7.83], p = 0.002). PCTpeak had the best single predictor of bacterial infection (area under the curve [AUC], 0.902, p < 0.001) with a sensitivity of 79.6 % and a specificity of 89.6 % at the threshold of 0.94 μg/L. PCTpeak was also positive correlation with severity of sepsis (r = 0.731, p = 0.002), but its correlation with SOFA score was only found in subjects with bacterial infection (r = 0.798, p < 0.001). Importantly, the 5-day PCT clearance (PCTc-d5), rather than absolute PCT values, could earlier discriminate survivors (n = 73) from nonsurvivors (n = 39) (68.8 ± 9.8 vs. 21.8 ± 17.5 %, p < 0.001, respectively). PCTc-d5 < 50 % was an independent predictor of mortality (odds ratio 5.1, 95 % confidence interval 3.5 to 7.5; p = 0.001).ConclusionsIn critically ill patients with AID, elevated PCT levels are valuable for bacterial infection and are significantly positive correlation with the septic severity. Five-day PCT clearance may provide independent prognostic information. Larger, prospective trials are warranted to confirm the benefit.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-015-0122-9) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 88%

The utility of initial procalcitonin and procalcitonin clearance for prediction of bacterial infection and outcome in critically ill patients with autoimmune diseases: a prospective observational study

Shi

Jiang

et al. 2015

BMC Anesthesiol

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“…18 Specifically, low serum PCT levels (<0.17 ng/ml) had >90% negative predictive value for ruling out bacterial infection in SLE patients. 19 A review of the literature published until 2014 indicated that raised PCT levels ≥0.5 μg/L should strongly suggest bacterial infection in the context of SLE. 20 However, there is limited data regarding the diagnostic accuracy of PCT in case of hemophagocytic syndrome, a severe condition which can mimic or complicate both lupus flare and infection.…”

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confidence: 99%

Flares in systemic lupus erythematosus: diagnosis, risk factors and preventive strategies

Adamichou¹,

Βertsias²

2017

MJR

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INTRODUCTION Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by a broad spectrum of symptoms and manifestations, encompassing almost all organs and tissues. Typically, its natural history follows a relapsing-remitting course with highly variable outcome and significant morbidity. Although patient survival rates have improved considerably over the last decades, most

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“…Whether PCT can serve as an indicator to distinguish the two statuses in SLE remains controversial. [12][13][14] Sfia et al 15 reported that in eight cases with severe drug eruption, one case of SJS and one case of drug rash with eosinophilia and systemic symptoms in the absence of bacterial infections had significantly elevated PCT levels. In such cases, PCT may not be a reliable marker to discriminate between infection and no infection.…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin as a diagnostic indicator for systemic bacterial infections in patients with Stevens–Johnson syndrome/toxic epidermal necrolysis

Wang

Xiao-bing

Liu

et al. 2018

The Journal of Dermatology

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Elevated serum procalcitonin (PCT) level has been reported to be a diagnostic index in systemic bacterial infections, but it can also increase in some non-infectious inflammatory diseases. Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) is a rare immune-mediated cutaneous mucosal reaction which is susceptible to bacterial infections and may have elevated PCT levels. The value of serum PCT has not been assessed in series of SJS/TEN patients. We aimed to investigate the PCT levels in SJS/TEN patients with systemic bacterial infections (systemic infected group), with skin surface bacterial infections (skin surface infected group) and without infections (non-infected group), to assess whether PCT was a valuable indicator for systemic bacterial infections in SJS/TEN patients. The PCT and C-reactive protein (CRP) levels of 42 inpatients with SJS/TEN were retrospectively analysis. The receiver-operator curve (ROC) was used to determine the diagnostic efficacy of PCT for systemic bacterial infections in SJS/TEN patients. The results demonstrated that PCT levels in the systemic infected group were significantly higher than those in the other two groups (P < 0.05). There was no significant difference in CRP between the three groups. The cut-off PCT level of 0.65 ng/mL calculated by ROC had optimal diagnostic efficacy, with sensitivity and specificity of 84.6% and 89.7%, respectively. PCT and severity-of-illness score for toxic epidermal necrolysis were positively correlated (P < 0.05). In conclusion, PCT is a valuable index and superior to CRP in detecting systemic bacterial infections in SJS/TEN patients. The level of PCT can partially reflect the severity of the disease.

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Serum procalcitonin has negative predictive value for bacterial infection in active systemic lupus erythematosus

Abstract: PCT may be a better marker to rule out bacterial infection in lupus flare but not in remission or general screening.

Cited by 36 publications

References 21 publications

The utility of initial procalcitonin and procalcitonin clearance for prediction of bacterial infection and outcome in critically ill patients with autoimmune diseases: a prospective observational study

The utility of initial procalcitonin and procalcitonin clearance for prediction of bacterial infection and outcome in critically ill patients with autoimmune diseases: a prospective observational study

Flares in systemic lupus erythematosus: diagnosis, risk factors and preventive strategies

Procalcitonin as a diagnostic indicator for systemic bacterial infections in patients with Stevens–Johnson syndrome/toxic epidermal necrolysis

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