Serum Calprotectin Discriminates Subclinical Disease Activity from Ultrasound-Defined Remission in Patients with Rheumatoid Arthritis in Clinical Remission

• DOI: 10.1371/journal.pone.0165498
• Publication Date: 2016-11-10T18:52:22Z
• Authors: Jana Hurnakova; Hana Hulejova; Jakub Zavada; Martin Komarc; Petra Hanova; Martin Klein; Herman Mann; Olga Sleglova; Marta Olejarova; Sarka Forejtova; Olga Ruzickova; Jiri Vencovsky; Karel Pavelka; Ladislav Senolt
• Keywords: Subclinical infection

Objective Clinical remission in some patients with rheumatoid arthritis (RA) may be associated ongoing synovial inflammation that is not always detectable on clinical examination or reflected by laboratory tests but can visualized musculoskeletal ultrasound. The goal of our study was to determine the levels serum calprotectin, a major leukocyte protein, RA and investigate ability calprotectin distinguish ultrasound-defined from those residual ultrasound subclinical inflammation. Methods Seventy underwent examination. Ultrasound performed according German US7 score. defined as grey scale (GS) range 0–1 power Doppler (PD) 0. C-reactive protein (CRP) were determined. discriminatory capacity CRP detecting assessed using ROC curves. Results total number fulfilling DAS28-ESR, DAS28-CRP, SDAI CDAI criteria 58, 67, 32 31, respectively. Residual found 58–67% who fulfilled at least one set criteria. Calprotectin significantly higher than (mean 2.5±1.3 vs. 1.7±0.8 μg/mL, p<0.005). Using criteria, had an AUC 0.692, p<0.05 DAS28-ESR 0.712, p<0.005 DAS28-CRP correctly distinguished activity 70% patients. (AUC = 0.494, p NS; 0.498, NS) lower insignificant capacity. Conclusion present demonstrates potential both disease activity.