Diagnostic value of procalcitonin for differentiation between bacterial infection and non-infectious inflammation in febrile patients with active adult-onset Still’s disease

D-Y Chen^1,2, Y-M Chen^1,2, W-L Ho^1,2, H-H Chen^1,2, G-H Shen³, J-L Lan^1,2

¹ Yang-Ming University and Chung-Hsing University, Taipei, Taiwan
² Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan
³ Chung-Hsing University, Taiwan, and Division of Chest Medicine, Taichung Veterans General Hospital, Taichung, Taiwan

Correspondence to:
Dr J-L Lan, Taichung Veterans General Hospital, No 160, Section 3, Taichung-Kang Road, Taichung City 40705, Taiwan; jllan@mail.vghtc.gov.tw

Accepted 22 August 2008

The first 150 words of the full text of this article appear below.

Adult-onset Still’s disease (AOSD) has been recognised as an important cause of fever of unknown origin. Over 99% of AOSD patients displayed fever during their disease course.¹ The diagnosis of bacterial infection in febrile AOSD patients is challenging because traditional markers of infection are often misleading. This prompted us to search for a reliable marker that allows early discrimination between non-infectious inflammation and bacterial infection in febrile AOSD patients.

Procalcitonin, a novel marker that can distinguish disease activity from infection, has been investigated in febrile patients with systemic lupus erythematosus (SLE).^{2 3} Procalcitonin has proved to be a diagnostic marker of infection in critically ill patients compared with other inflammatory parameters.⁴ Serum procalcitonin is normally undetectable (<0.05 ng/ml) and procalcitonin levels of 0.5 ng/ml or greater can distinguish infection from non-infectious inflammation.^{3 5} Contradictory results for procalcitonin have recently been reported in AOSD because of the investigation of only small sample groups.^{5 6}

. . . [Full text of this article]

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