Estudio de precisión diagnóstica de la velocidad de sedimentación globular y la proteína C reactiva en pacientes con lupus eritematoso sistémico y fiebre admitidos en un hospital de la Seguridad Social en Lima, Perú, 2010-2019

Translated title of the contribution: Diagnostic accuracy study of globular sedimentation rate and C-reactive protein in patients with systemic lupus erythematosus and fever admitted to a Social Security hospital in Lima, Peru, 2010-2019

Gustavo R. León, Ayleen Menacho-Alvarado, Jorge Cieza-Calderón, Eddy R. Segura

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: In patients with systemic lupus erythematosus (SLE) and fever, the causes are infection and/or activity. We assessed the diagnostic accuracy of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) to discern these causes. Methods: We reviewed medical records of patients with SLE and fever hospitalized from 2010-2019. Based on two categories of cause of fever (infection with-or-without activity versus activity alone), we computed ROC curves, areas under the curve (AUC) and best cut-off values for ESR, parameter ESR, CRP and ESR/CRP ratio. In addition, we calculated sensitivity, specificity, and predictive values. Results: We included 40 cases (34 women) with an average age of 35.5 years. The main cause of fever was the coexistence of infection and activity (17/40; 43%), followed by fever only due to activity (14/40; 35%). The most frequent infection was pneumonia (10/40; 25%) and the most common activity was renal (21/40; 53%). To diagnose”fever due to infection with-or-without activity”, compared to “fever only due to activity”, CRP had an AUC: .86 (95% CI: .75-.97) with 5.4 mg/dl as the best cut-off value (Se: 76.9%; Sp: 85.7%; PPV: 90.9; NPV: 66.6%). To diagnose “fever due to activity only”, compared to “fever due to infection with or without activity”, the ESR/CRP ratio had an AUC: .83 (95% CI: .68-.98) with 21.42 as the best cut-off value (Se: 78.6%; Sp: 84.6%; PPV: 73.3%; NPV: 88.0%). Conclusion: CRP and ESR/CRP ratio, which are routine tests in these cases, are potentially useful in discerning causes of fever in SLE patients. These findings should be confirmed in future studies.

Translated title of the contributionDiagnostic accuracy study of globular sedimentation rate and C-reactive protein in patients with systemic lupus erythematosus and fever admitted to a Social Security hospital in Lima, Peru, 2010-2019
Original languageSpanish
JournalRevista Colombiana de Reumatologia
DOIs
StateAccepted/In press - 2022
Externally publishedYes

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