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Open AccessArticle

Modestly Elevated Serum Procalcitonin Levels in Patients with Rheumatoid Arthritis Free of Active Infection

1
Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 62247, Taiwan
2
Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 62247, Taiwan
3
School of Medicine, Tzu Chi University, Hualien City, Hualien 97071, Taiwan
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Medicina 2020, 56(10), 545; https://doi.org/10.3390/medicina56100545
Received: 8 September 2020 / Revised: 13 October 2020 / Accepted: 16 October 2020 / Published: 17 October 2020
(This article belongs to the Section Immunology)
Background and objectives: To investigate the serum procalcitonin (PCT) levels among patients with rheumatoid arthritis (RA) without active infection compared with healthy controls and to understand the relationship of PCT with RA disease activity, and treatment received by patients. Materials and Methods: Patients aged 20 years and above with clinician-confirmed diagnosis of RA and healthy volunteers were included during regular outpatient visits, and those with active infection symptoms and signs were excluded. RA disease activity was measured using the Disease Activity Score-28 for Rheumatoid Arthritis with erythrocyte sedimentation rate (DAS28-ESR). Medications received by the patients were also recorded. Results: A total of 623 patients with RA and 87 healthy subjects were recruited in this study. The mean PCT were significantly higher in patients with RA (6.90 ± 11.81 × 10−3 ng/mL) compared with healthy controls (1.70 ± 6.12 × 10−3 ng/mL) (p < 0.001) and the difference remained statistically significant after adjusting for age and sex. In addition, multiple linear regression analysis showed that a lower rank-transformed PCT serum level was significantly correlated with the use of biologics (p = 0.017) and a high DAS28-ESR score (p = 0.028) in patients with RA. Conclusion: Patients with RA have a significantly higher serum PCT levels compared with healthy controls. The use of biologics and an active RA disease activity were associated with a lower level of PCT in patients with RA. Further investigation is required to determine the optimal cutoff value of PCT among patients with RA and its association with disease activity and biologic usage. View Full-Text
Keywords: rheumatoid arthritis; procalcitonin; disease activity index; infection; disease activity rheumatoid arthritis; procalcitonin; disease activity index; infection; disease activity
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Ng, K.-J.; Yu, H.-C.; Huang Tseng, H.-Y.; Hsu, C.-W.; Lu, M.-C. Modestly Elevated Serum Procalcitonin Levels in Patients with Rheumatoid Arthritis Free of Active Infection. Medicina 2020, 56, 545.

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