Abstract
The severity of systemic lupus erythematosus (SLE) patients with pulmonary bacterial infection varies widely. We investigated the significance of procalcitonin (PCT) and C-reactive protein (CRP) in evaluating the severity of pulmonary infection in SLE patients. This retrospective study contained a total of 117 patients (107 women and 10 men) with SLE from January 2010 to June 2011. Serum levels of PCT and CRP were measured by enzyme-linked immunosorbent assay. The severity of pulmonary bacterial infection (PBI) was evaluated using the pneumonia severity index (PSI). SLE patients with PBI, particularly those with bacterial isolates, had significantly higher levels of serum PCT and CRP than those without PBI. Serum PCT and CRP were not associated with SLE disease activity, but positively with the values of PSI in active SLE patients with PBI. Serum levels of PCT and CRP may be additional biomarkers in evaluating the severity of PBI in lupus patients.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Pons-Estel GJ, Alarcon GS, Scofield L, et al. Understanding the epidemiology and progression of systemic lupus erythematosus. Semin Arthritis Rheum, 2010,39(4):257–268
Smith PP, Gordon C. Systemic lupus erythematosus: clinical presentations. Autoimmun Rev, 2010,10(1):43–45
Sciascia S, Cuadrado MJ, Karim MY. Management of infection in systemic lupus erythematosus. Best Pract Res Clin Rheumatol, 2013,27(3):377–389
Mok CC, Lee KW, Ho CT, et al. A prospective study of survival and prognostic indicators of systemic lupus erythematosus in a southern Chinese population. Rheumatology (Oxford), 2000,39(4):399–406
Navarro-Zarza JE, Alvarez-Hernandez E, Casasola-Vargas JC, et al. Prevalence of community-acquired and nosocomial infections in hospitalized patients with systemic lupus erythematosus. Lupus, 2010,19(1):43–48
Segal BH, Sneller MC. Infectious complications of immunosuppressive therapy in patients with rheumatic diseases. Rheum Dis Clin North Am, 1997,23(2):219–237
Navarra SV, Leynes MS. Infections in systemic lupus erythematosus. Lupus, 2010,19(12):1419–1424
Muller B, Harbarth S, Stolz D, et al. Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia. BMC Infect Dis, 2007,7:10
Simon L, Gauvin F, Amre DK, et al. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis, 2004,39(2):206–217
Lanoix JP, Bourgeois AM, Schmidt J, et al. Serum procalcitonin does not differentiate between infection and disease flare in patients with systemic lupus erythematosus. Lupus, 2011,20(2):125–130
Kim MH, Lim G, Kang SY, et al. Utility of procalcitonin as an early diagnostic marker of bacteremia in patients with acute fever. Yonsei Med J, 2011,52(2):276–281
Bellmann-Weiler R, Ausserwinkler M, Kurz K, et al. Clinical potential of C-reactive protein and procalcitonin serum concentrations to guide differential diagnosis and clinical management of pneumococcal and Legionella pneumonia. J Clin Microbiol, 2010,48(5):1915–1917
Giamarellos-Bourboulis EJ, Tsangaris I, Kanni T, et al. Procalcitonin as an early indicator of outcome in sepsis: a prospective observational study. J Hosp Infect, 2011,77(1):58–63
Kotoula A, Gardikis S, Tsalkidis A, et al. Procalcitonin for the early prediction of renal parenchymal involvement in children with UTI: preliminary results. Int Urol Nephrol, 2009,41(2):393–399
Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum, 1997,40(9):1725
Bombardier C, Gladman DD, Urowitz MB, et al. Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum, 1992,35(6):630–640
Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med, 1997,336(4):243–250
Guerin S. Evaluation of the detection of procalcitonin by an immuno-chromatography test: Brahms PCT-Q. Ann Biol Clin (Paris), 2000,58(5):613–614
Eberhard OK, Haubitz M, Brunkhorst FM, et al. Usefulness of procalcitonin for differentiation between activity of systemic autoimmune disease (systemic lupus erythematosus/ systemic antineutrophil cytoplasmic antibody-associated vasculitis) and invasive bacterial infection. Arthritis Rheum, 1997,40(7):1250–1256
Quintana G, Medina YF, Rojas C, et al. The use of procalcitonin determinations in evaluation of systemic lupus erythematosus. J Clin Rheumatol, 2008,14(3):138–142
Kim HA, Jeon JY, An JM, et al. C-reactive protein is a more sensitive and specific marker for diagnosing bacterial infections in systemic lupus erythematosus compared to S100A8/A9 and procalcitonin. J Rheumatol, 2012,39(4):728–734
Bador KM, Intan S, Hussin S, et al. Serum procalcitonin has negative predictive value for bacterial infection in active systemic lupus erythematosus. Lupus, 2012,21(11):1172–1177
Uramoto KM, Michet CJ, Thumboo J, et al. Trends in the incidence and mortality of systemic lupus erythematosus, 1950-1992. Arthritis Rheum, 1999,42(1):46–50
Rowther FB, Rodrigues CS, Deshmukh MS, et al. Prospective comparison of Eubacterial PCR and measurement of procalcitonin levels with blood culture for diagnosing septicemia in intensive care unit patients. J Clin Microbiol, 2009,47(9):2964–2969
Author information
Authors and Affiliations
Corresponding author
Additional information
This project was supported by Science and Technology Department of Henan Province, China (No. 142300410327).
Rights and permissions
About this article
Cite this article
Gao, J., Zhang, L., Zhang, X. et al. Levels of serum procalcitonin and C-reactive protein for evaluating pulmonary bacterial infection in patients with lupus erythematosus. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 36, 653–658 (2016). https://doi.org/10.1007/s11596-016-1641-4
Received:
Revised:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11596-016-1641-4