title: Is serum procalcitonin measurement a useful addition to a rheumatologist's repertoire? A review of its diagnostic role in systemic inflammatory diseases and joint infections.
abstract: Early differentiation between infection and aseptic inflammation is difficult and is a challenge often faced in the rheumatology practice. Procalcitonin (PCT) is a biomarker that is preferentially induced in patients with bacterial infections, and a growing body of evidence supports its use for improving diagnosis of bacterial infections and guiding antibiotic therapy. In this article, we review the evidence for the use of PCT measurement in rheumatology practice. Several studies have examined the use of PCT to assist in the differentiation between septic and non-septic arthritis in patients with an inflamed joint and found it to be a sensitive and specific marker of infection. A number of studies in patients with diverse inflammatory rheumatic diseases have provided useful information regarding the usefulness of PCT in these patients. In summary, PCT when used in the appropriate clinical setting can be a useful adjunct to currently available laboratory infection markers, though further studies are warranted. Furthermore, PCT results should be interpreted in parallel with the clinical assessment.
authors.affiliation: Department of Rheumatology, James Cook University Hospital, Middlesbrough, UK and Department of Rheumatology & Clinical Immunology, University Medical Center, Utrecht, The Netherlands doctormshaikh@gmail.com.
authors.forename: Muddassir Muhammad
authors.initials: MM
authors.lastname: Shaikh
authors.affiliation: Department of Rheumatology, James Cook University Hospital, Middlesbrough, UK and Department of Rheumatology & Clinical Immunology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Lucas Etienne
authors.initials: LE
authors.lastname: Hermans
authors.affiliation: Department of Rheumatology, James Cook University Hospital, Middlesbrough, UK and Department of Rheumatology & Clinical Immunology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Jacob M
authors.initials: JM
authors.lastname: van Laar
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001168:Arthritis / Q000175:diagnosis*; D001170:Arthritis, Infectious / Q000175:diagnosis; D001172:Arthritis, Rheumatoid / Q000175:diagnosis; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D016459:Prosthesis-Related Infections / Q000175:diagnosis; D011498:Protein Precursors / Q000097:blood*; D016706:Still's Disease, Adult-Onset / Q000175:diagnosis; D056647:Systemic Vasculitis / Q000175:diagnosis
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; C000606589:CALCA protein, human; D007166:Immunosuppressive Agents; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
keywords: bacterial infection; inflammatory rheumatic disease; procalcitonin; septic arthritis