Prospective Evaluation of Procalcitonin, Soluble Triggering Receptor Expressed on Myeloid Cells-1 and C-Reactive Protein in Febrile Patients with Autoimmune Diseases.
Prospective Evaluation of Procalcitonin, Soluble Triggering Receptor Expressed on Myeloid Cells-1 and C-Reactive Protein in Febrile Patients with Autoimmune Diseases.
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BACKGROUND:Both procalcitonin (PCT) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) have been investigated separately as indicators of infection in patients with autoimmune diseases.Our study simultaneously evaluated both PCT and sTREM-1 along with C-reactive protein (CRP) in febrile patients with autoimmune diseases.METHODS:Fifty-nine patients were enrolled in the study.
The patients were categorized into the infection group (n=24) or the disease flare group (n=35).sTREM-1, PCT and CRP concentrations at fever onset were compared between am22 pro model the two groups of patients.RESULTS:sTREM-1 and CRP did not differ between the two groups.
PCT [median (range), ng/ml] was higher in the infection group than in the disease flare group [0.53 (0.02-12.
85) vs.0.12 (0.
02-19.23), p=0.001].
The area under the receiver-operating characteristic (ROC) for diagnosis of infection was 0.75 for PCT (p=0.001), 0.
63 for CRP (p=0.09) and 0.52 for sTREM-1 (p=0.
79).Using 0.2 ng/ml as the cutoff value for PCT, sensitivity was 0.
75 and specificity was 0.77.Negative predictive values for PCT were 92%, 87% and 82% for a prevalence of infection of 20%, 30%, and 40%, respectively.
Neither immunosuppressants nor biomodulators affected the level of the three biomarkers.However, in patients igora 9.5-18 treated with corticosteroids, the levels of sTREM-1 and CRP were significantly decreased compared with the untreated patients.CONCLUSIONS:Setting PCT at a lower cutoff value could provide useful information on excluding infection in febrile patients with autoimmune diseases.
The possible effect of corticosteroids on the level of sTREM-1 as an infection marker deserves further study.