calca-protein--human and Granulomatosis-with-Polyangiitis

Data on the origin and biological function of procalcitonin, the pro-hormone of calcitonin, are scarce. Since this peptide can be induced in bacterial invasive infections, serum procalcitonin levels may be useful in differential diagnosis of systemic inflammatory response syndrome. This review will focus on the clinical significance of changes in serum procalcitonin levels in patients with connective tissue diseases and other rheumatic disorders.

Topics: Arthritis, Rheumatoid; Autoimmune Diseases; Bacterial Infections; Calcitonin; Calcitonin Gene-Related Peptide; Connective Tissue Diseases; Diagnosis, Differential; Granulomatosis with Polyangiitis; Humans; Lupus Erythematosus, Systemic; Mycoses; Protein Precursors; Rheumatic Diseases; Virus Diseases

Differential diagnosis of infection during active immune disease, such as Wegener's granulomatosis (Wegener's granulomatosis), is a major clinical challenge. Laboratory measures, erythrocyte sedimentation rate or C-reactive protein, can be elevated in infections that supervene, or coinciding with, in active Wegener's granulomatosis, and thus are nonspecific. The aim of the study was to compare the serum levels of procalcitonin (PCT) in patients with active and inactive disease. Twenty two sera were tested from 10 patients with active, generalized, and biopsyproven Wegener's granulomatosis, with pulmonary involvement, and 12 patients with nonactive one. PCT levels were measured using an immunoluminometric assay. The PCT level was markedly elevated (1.2-3.6 ng/ml) in 9 of the 10 sera from active and 2 of the 12 sera from nonactive Wegener's granulomatosis. PCT levels were in the normal range (0.28-0.56 ng/ml) in the remaining patients with nonactive Wegener's granulomatosis. We conclude that serum procalcitonin levels may be a potentially useful marker in the diagnosis of bacterial infection supervening in active Wegener's granulomatosis.

Topics: Adult; Aged; Antibodies, Antineutrophil Cytoplasmic; Bacterial Infections; Biomarkers; Blood Sedimentation; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Enzyme-Linked Immunosorbent Assay; Female; Fibrinogen; Fluorescent Antibody Technique, Indirect; Glomerular Filtration Rate; Granulomatosis with Polyangiitis; Hemoglobins; Humans; Leukocyte Count; Lung Diseases; Male; Middle Aged; Platelet Count; Protein Precursors; Staphylococcal Infections; Young Adult

To compare serum levels of procalcitonin (PCT) in patients with Wegener's granulomatosis (WG) in both active and inactive disease states to determine if PCT levels are increased in active WG without infection.. Sera were tested from 26 patients with generalized histologically proven WG, one sample taken during an active and one during an inactive disease state. PCT serum levels were measured using an immunoluminometric assay.. PCT levels were in the normal range (0-0.5 ng/ml) in 23 of 26 sera taken during active WG and in all 26 sera taken during inactive WG. In sera from 3 patients with highly active WG, serum PCT concentrations were markedly elevated (0.8-3.3 ng/ml). There was a slight but significant difference in PCT concentrations between sera taken during active versus inactive disease. PCT values were found to correlate slightly with other disease activity variables (erythrocyte sedimentation rate, C-reactive protein, soluble interleukin 2 receptor, antineutrophil cytoplasmic antibodies) and with the Disease Extent Index score.. PCT serum levels may be a potentially useful variable in the differential diagnosis of flares and bacterial infection in patients with WG. Interpretation of the values must be supported by laboratory and clinical findings, since PCT levels can be elevated in rare cases of highly active WG without infection.

Topics: Bacterial Infections; Calcitonin; Calcitonin Gene-Related Peptide; Diagnosis, Differential; Granulomatosis with Polyangiitis; Humans; Protein Precursors

To investigate whether the determination of serum procalcitonin (PCT) in systemic autoimmune disease will help to discriminate invasive infection from highly active underlying disease.. Three hundred ninety-seven serum samples, from 18 patients with systemic lupus erythematosus (SLE) and 35 patients with systemic antineutrophil cytoplasmic antibody-associated vasculitis (AAV), were analyzed. Clinical disease activity was assessed by the Systemic Lupus Activity Measure in SLE patients and by the Birmingham Vasculitis Activity Score in AAV patients. Procalcitonin concentrations were determined in parallel with concentrations of neopterin, interleukin-6 (IL-6), and C-reactive protein (CRP). Additionally, serum creatinine values were obtained.. In 321 of the 324 samples from the 42 patients with autoimmune disease but without systemic infection, serum PCT levels were within the normal range (i.e., <0.5 ng/ml), whereas the values for neopterin, IL-6, and CRP were elevated in patients with active underlying disease. All 16 systemic infections occurred in 11 patients with AAV, and were associated with PCT levels that were markedly elevated, to a mean +/- SD of 1.93 +/- 1.19 ng/ml. No correlation between the degree of renal impairment and PCT concentrations was seen.. PCT may serve as a useful marker for the detection of systemic bacterial infection in patients with systemic autoimmune disease.

Topics: Antibodies, Antineutrophil Cytoplasmic; Autoimmune Diseases; Bacterial Infections; Biomarkers; Biopterins; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Creatinine; Diagnosis, Differential; Glycoproteins; Granulomatosis with Polyangiitis; Humans; Interleukin-6; Lupus Erythematosus, Systemic; Neopterin; Protein Precursors; Vasculitis