Diagnostic value of procalcitonin for differentiation between bacterial infection and noninfectious inflammation in febrile children with systemic autoimmune diseases
Objectives: The objective of this study is to determine the diagnostic value of procalcitonin (PCT) for differentiation between bacterial infection and noninfectious inflammation in febrile children with systemic autoimmune disease. Methods: It was a cross-sectional study and children with systemic...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2018-01-01
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| Series: | Indian Journal of Rheumatology |
| Subjects: | |
| Online Access: | http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2018;volume=13;issue=3;spage=173;epage=177;aulast=Loganathan |
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| Summary: | Objectives: The objective of this study is to determine the diagnostic value of procalcitonin (PCT) for differentiation between bacterial infection and noninfectious inflammation in febrile children with systemic autoimmune disease.
Methods: It was a cross-sectional study and children with systemic autoimmune disease such as systemic lupus erythematosus (SLE) and juvenile idiopathic arthritis (JIA) presenting with fever (>38°C) were recruited.
Results: Out of 24 children included, 16 had SLE (11 in disease flare group and 5 in infection group) and 8 had disease flare of Systemic JIA. Two children in SLE infection group died. Mean PCT was 92.2 ng/ml in SLE infectious group and 3.50 ng/ml in SLE flare group which was statistically significant (P = 0.009). However, the mean C-reactive protein was 98 mg/dl in SLE infectious group and 52 mg/dl in SLE flare group which was not statistically significant (P = 0.25). PCT concentration cutoff value >1.2 ng/ml has the sensitivity of 83% (95% confidence interval [CI] 43.6–0.97) and specificity of 72% (95% CI 49.1–87.5), positive predictive value of 50% (95% CI 23.6–76.3) and negative predictive value 93% (95% CI 68.5–98.7).
Conclusions: PCT levels >1.2 ng/ml in febrile SLE patients should point to a bacterial infection, whereas PCT levels <1.2 ng/ml might indicate disease flare that could reduce unnecessary antibiotic use. PCT may serve as a useful marker for the detection of systemic bacterial infection in patients with the systemic autoimmune disease. |
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| ISSN: | 0973-3698 0973-3701 |