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CD64 as a potential biomarker in septic arthritis
Oddvar Oppegaard1, Brita Skodvin, Anne-Kristine Halse
1Department of Medicine, Haukeland University Hospital, Bergen, Norway. Oddvar.oppegaard@helse-bergen.no
BMC Infectious Diseases
|June 21, 2013
Summary
Fc-gamma-receptor type 1, CD64, and procalcitonin (PCT) show high specificity for septic arthritis but limited sensitivity. C-reactive protein (CRP) offers the best diagnostic accuracy for acute arthritis, though CD64 and PCT improve with specific exclusions.
Area of Science:
- Rheumatology
- Infectious Diseases
- Clinical Diagnostics
Background:
- Traditional inflammatory markers lack specificity in differentiating septic arthritis from other inflammatory joint diseases.
- Acute arthritis diagnosis requires reliable markers to distinguish infectious from non-infectious causes.
Purpose of the Study:
- To evaluate the diagnostic discriminatory power of Fc-gamma-receptor type 1 (CD64) compared to traditional markers and procalcitonin (PCT) in acute arthritis.
- To assess the utility of CD64 in identifying septic arthritis.
Main Methods:
- Prospective study (June 2009-December 2011) including patients with rheumatic arthritis, crystal-induced arthritis, and septic arthritis.
- Measurement of traditional inflammatory markers, CD64, and PCT.
- Comparative analysis of diagnostic abilities using ROC curves.
Main Results:
- CD64 and PCT exhibited high specificity (98%) but low sensitivity (59% and 52%).
- C-reactive protein (CRP) demonstrated the best diagnostic accuracy (AUC 0.92).
- Excluding specific septic arthritis subgroups improved CD64 and PCT accuracy, but not CRP or WBC.
Conclusions:
- CD64 and PCT are highly specific for infection, primarily reflecting bacteremia.
- The clinical utility of CD64 and PCT in hospital practice, particularly for localized infections, requires further definition.
