Procalcitonin at the onset of giant cell arteritis and polymyalgia rheumatica: the GRACG prospective study.
OBJECTIVE
An epidemic pattern has been reported for GCA and PMR. Immunological studies have shown that an unknown antigen activates the dendritic cells of the adventitia and the type 4 toll-like receptors. Procalcitonin (PCT) is an early marker of bacterial infection. The goal of the study was to assess the level of PCT in GCA and PMR at the onset of the disease.


METHODS
Patients diagnosed during the 2002-06 period were randomly selected. All the 46 patients fulfilled the ACR or the Hunder criteria, and all blood samples were taken before steroid therapy.


RESULTS
PCT was normal in all patients. PCT was slightly increased in men (0.087 +/- 0.023 microg/l) compared with women (0.066 +/- 0.027 microg/l) (P = 0.009), and in PMR (0.092 +/- 0.027 microg/l) compared with GCA (0.068 +/- 0.026 microg/l) (P = 0.018). There was no significant correlation with inflammation markers.


CONCLUSIONS
These results are not in favour of a bacterial trigger for GCA or PMR. Increased PCT levels in patients with inflammatory syndrome, GCA-PMR symptoms and negative temporal artery biopsy may rule out the diagnosis of GCA and PMR.
Schmidt
J
J
Department of Internal Medicine, Place Victor Pauchet, Amiens University Hospital, 80000 Amiens CEDEX 1, France. schmidt.jean@chu-amiens.fr
Duhaut
P
P
Bourgeois
A M
AM
Salle
V
V
Smail
A
A
Chatelain
D
D
Betsou
F
F
Mazière
J C
JC
Ducroix
J P
JP
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D013700:Giant Cell Arteritis / Q000097:blood* / Q000276:immunology; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000097:blood* / Q000276:immunology; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012737:Sex Factors; D012907:Smoking
D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide