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Rheumatology Advance Access published online on December 20, 2008
Rheumatology, doi:10.1093/rheumatology/ken437
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Procalcitonin at the onset of giant cell arteritis and polymyalgia rheumatica: the GRACG prospective study

J. Schmidt1, P. Duhaut1, A.M. Bourgeois2, V. Salle1, A. Smail1, D. Chatelain3, F. Betsou4, J.C. Mazière2, J.P. Ducroix1 and members of the Groupe de Recherche sur l’Artérite à Cellules Géantes (GRACG)

1Department of Internal Medicine and RECIF, 2Laboratory of Biochemistry, 3Department of Pathology and 4Biobank of Picardie, Amiens University Hospital, Amiens, France.

Correspondence to: J. Schmidt, Department of Internal Medicine, Place Victor Pauchet, Amiens University Hospital, 80000 Amiens CEDEX 1, France. E-mail: schmidt.jean{at}chu-amiens.fr


  Abstract

Objectives. 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 µg/l) compared with women (0.066 ± 0.027 µg/l) (P = 0.009), and in PMR (0.092 ± 0.027µg/l) compared with GCA (0.068 ± 0.026 µg/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.

KEY WORDS: Giant cell arteritis, Polymyalgia rheumatica, Procalcitonin, Infectious trigger

Submitted 6 August 2008; revised version accepted 17 October 2008.
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