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ORIGINAL ARTICLE
Year : 2018  |  Volume : 13  |  Issue : 3  |  Page : 173-177

Diagnostic value of procalcitonin for differentiation between bacterial infection and noninfectious inflammation in febrile children with systemic autoimmune diseases


Department of Pediatrics Unit II, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
Dr. Sathish Kumar
Department of Paediatrics Unit II, Christian Medical College, Vellore - 632 004, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/injr.injr_54_18

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Objectives: The objective of this study is to determine the diagnostic value of procalcitonin (PCT) for differentiation between bacterial infection and noninfectious inflammation in febrile children with systemic autoimmune disease. Methods: It was a cross-sectional study and children with systemic autoimmune disease such as systemic lupus erythematosus (SLE) and juvenile idiopathic arthritis (JIA) presenting with fever (>38°C) were recruited. Results: Out of 24 children included, 16 had SLE (11 in disease flare group and 5 in infection group) and 8 had disease flare of Systemic JIA. Two children in SLE infection group died. Mean PCT was 92.2 ng/ml in SLE infectious group and 3.50 ng/ml in SLE flare group which was statistically significant (P = 0.009). However, the mean C-reactive protein was 98 mg/dl in SLE infectious group and 52 mg/dl in SLE flare group which was not statistically significant (P = 0.25). PCT concentration cutoff value >1.2 ng/ml has the sensitivity of 83% (95% confidence interval [CI] 43.6–0.97) and specificity of 72% (95% CI 49.1–87.5), positive predictive value of 50% (95% CI 23.6–76.3) and negative predictive value 93% (95% CI 68.5–98.7). Conclusions: PCT levels >1.2 ng/ml in febrile SLE patients should point to a bacterial infection, whereas PCT levels <1.2 ng/ml might indicate disease flare that could reduce unnecessary antibiotic use. PCT may serve as a useful marker for the detection of systemic bacterial infection in patients with the systemic autoimmune disease.


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