Procalcitonin can increase during activation of adult-onset Still's disease (AOSD) in the absence of an ınfection focus.

Abstract

Dear Editor, The serum procalcitonin (PCT) assay has been widely used in our daily practice, particularly when distinguishing between infectious and non-infectious causes of acute febrile illness. Although its widespread implementation has drastically diminished unnecessary antibiotic use throughout the recent years, it should be kept in mind that elevations in serum PCT levels might rarely be observed in some conditions such as trauma, postsurgical, severe burns, acute biliary pancreatitis, medullary thyroid carcinoma and renal insufficiency without evidence of an infection source [1]. Its applicability in systemic autoimmune disorders has been studied with promising high sensitivity compared with C-reactive protein (CRP) in discriminating an infectious foci whilst acute feverish presentation [2]. However, there are some interesting reports that high levels can also be seen in adult-onset Still’s disease (AOSD) patients in the absence of infections [3, 4]. Herein, with the report of this mini observation we intended to attract attention that PCT might increase as a part of AOSD itself and discuss some possible pathogenic mechanisms.