Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

CRP levels in autoimmune disease can be specified by measurement of procalcitonin


Autoimmune diseases (AID) are prone to infection particularly under immunosuppression. The differentiation of infection from active AID is often difficult. In order to specify the diagnostic value of measurement of procalcitonin (PCT) in AID 81 patients with anti-neutrophil cytoplasmic antibody (ANCA)-positive vasculitis were analyzed, 27 with rheumatoid arthritis and 25 patients with systemic lupus erythematosus at various stages of the disease. Although PCT levels (95th percentile) were below 0.5 ng/ml in patients with active systemic lupus erythematosus and rheumatoid arthritis, the cutoff for normal values (95th percentile) in patients with active ANCA-positive vasculitis was 0.89. Therefore PCT levels of <1 ng/ml are recommended as cutoff for invasive infections in patients with ANCA-positive vasculitis. In view of the increased mortality under immunosuppression in patients with AID and additional bacterial infection the measurement of PCT is helpful when an infectious origin is suspected.

This is a preview of subscription content, log in to check access.


  1. 1.

    Assicot, M., Gendrel, D., Carsin, H., Rymoand, J., Guibaud, J., Rohuon, C.: High serum procalcitonin concentrations in patients with sepsis and infection. Lancet 341 (1993) 515–518.

  2. 2.

    Gendrel, D., Bohuon, C.: Procalcitonin, a marker of bacterial infection. Infection 25 (1997) 133–134.

  3. 3.

    Karazai, W., Oberhoffer, M., Meier-Hellmann, A., Reinhart, K.: Procalcitonin-a new indicator of the systemic response to severe infections. Infection 25 (1997) 329–333.

  4. 4.

    Bradley, J. D., Brandt, K. D., Katz, B.: Infectious complications of cyclophosphamide treatment for vasculitis. Arthritis Rheum. 32 (1989) 45–53.

  5. 5.

    Neild, G. H.: Infectious complications in the management of systemic vasculitis and rapidly progressive glomerulonephritis. APMIS Suppl. 98 (1990) 56–60.

  6. 6.

    Eberhard, O. K., Haubitz, M., Brunkhorst, F. M., Kliem, V., Koch, K. M., Brunkhorst, R.: Usefulness of procalcitonin for differentiation between activity of systemic autoimmune disease (systemic lupus erythematousus/systemic antineutrophil cytoplasmatic antibody-associated vasculitis) and invasive bacterial infection. Arthritis Rheum. 40 (1997) 1250–1256.

  7. 7.

    Jennette, J. C., Falk, R. J., Andrassy, K., Bacon, B., Churg, J., Gross, W. L., Hagen, C., Hoffman, G. S., Hunder, G. G., Kallenberg, C. G. M., McCluskey, R. T., Sinico, R. A., Rees, A. J., vanEs, L. A., Waldherr, R., Wiik, A.: Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum 37 (1994) 187–192.

  8. 8.

    Luqmani, R. A., Bacon, P. A., Moots, R. J., Janssen, B. A., Pall, A., Emery, P., Savage, C., Adu, D.: Birmingham vasculitis activity score (BVAS) in systemic necrotizing vasculitis. Quart. J. Med. 87, (1994) 671–678.

  9. 9.

    Bombardier, C., Gladman, D. D., Urowitz, M. B., Caron, D., Chang, C. H., and theCommittee on Prognosis Studies in SLE: Derivation of the Sledai. A disease activity index for lupus patients. Arthritis Rheum. 35 (1992) 630–640.

  10. 10.

    Arnett, F. C., Edworthy, S. M., Bloch, D. A., McShane, D. J., Fries, J. F., Cooper, N. S., Healey, L. A., Kaplan, S. R., Liang, M. H., Luthra, H. S., Medsger, T. A., Mitchell, D. M., Neustadt, D. H., Pinals, R. S., Schaller, J. G., Sharp, J. T., Wider, R. L., Hunder, G. G.: The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 31 (1988) 315–324.

  11. 11.

    Pepsy, M. B.: C-reactive protein fifty years on. Lancet i (1981) 653–657.

  12. 12.

    Dandona, P., Nix, D., Wilson, M. F., Aljada, A., Love, J., Assicot, M., Bohuon, C.: Procalcitonin increase after endotoxin injection in normal subjects. J. Clin. Endocrinol. Metabol. 79 (1994) 1605–1608.

  13. 13.

    Meisner, M., Tschaikowsky, K., Schmidt, J., Schüttler, J.: Procalcitonin-indications for a new diagnostic parameter of severe bacterial infection and sepsis in transplantation, immunosuppression and cardiac assist devices. Cardiovascular Engineering 1 (1996) 67–76.

  14. 14.

    Weidemann, S., Andrassy, K., Ritz, E.: ANCA in haemodialysis patients. Nephrol. Dial. Transplant. 8 (1993) 839–845.

Download references

Author information

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Schwenger, V., Sis, J., Breitbart, A. et al. CRP levels in autoimmune disease can be specified by measurement of procalcitonin. Infection 26, 274–276 (1998).

Download citation


  • Rheumatoid Arthritis
  • Systemic Lupus Erythematosus
  • Vasculitis
  • Procalcitonin
  • Active Systemic Lupus Erythematosus