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Elevated Procalcitonin in Acute Pseudogout Flare: A Case Report.
Shilpa Vasishta1, Satya Patel1
1Internal Medicine, University of California Los Angeles, Los Angeles, USA.
Cureus
|August 15, 2019
Summary
An elderly patient with pseudogout experienced elevated procalcitonin levels, a biomarker typically used for infection. This case suggests procalcitonin may rise in non-infectious inflammatory conditions like crystal arthropathy.
Area of Science:
- Rheumatology
- Internal Medicine
- Biomarker Research
Background:
- Systemic Inflammatory Response Syndrome (SIRS) in elderly patients can be challenging to diagnose.
- Procalcitonin is a biomarker investigated for differentiating infectious from non-infectious causes of SIRS.
- Calcium Pyrophosphate Deposition (CPPD) disease, or pseudogout, can mimic infectious presentations.
Observation:
- An 86-year-old male presented with fever and tachycardia, initially suspected to be sepsis.
- Despite a negative infectious workup, the patient had an elevated procalcitonin level.
- The patient developed painful knee effusions consistent with pseudogout, which resolved with anti-inflammatory treatment.
Findings:
- This case is the first to report an elevated procalcitonin level specifically associated with an acute pseudogout flare.
- The findings suggest that procalcitonin may be elevated in acute crystal arthropathies.
- Elevated procalcitonin in this context highlights the complexity of interpreting this biomarker.
Implications:
- The study underscores the need for further research into procalcitonin's utility in non-infectious inflammatory states.
- Clinical interpretation of procalcitonin levels requires consideration of conditions beyond infection, such as crystal arthropathies.
- This case expands the understanding of pseudogout as a cause of SIRS and its impact on biomarker levels.
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