Autoinflammatory & rare systemic diseases
Clinical significance of non-infectious procalcitonin elevation in Still’s disease: a predictor of macrophage activation syndrome
Authors' conclusion
Elevated PCT levels may serve as an independent predictor of MAS in SD.
Study context
- Population
- Patients with Still's disease without infection with available procalcitonin (PCT) datapatients with SD
- Participants
- 110 patients
- Exposure
- SD with non-infectious PCT ≥ 0.5 vs PCT < 0.5 ng/ml (baseline and maximum values); controls with bloodstream infection and matched healthy controls (HCs)
- PCT ≥ 0.5n = 35
- PCT < 0.5n = 75reference
- PCTmax ≥ 0.5n = 47
- PCTmax < 0.5n = 63reference
- Outcome
- Relationship between non-infectious PCT elevation and clinical features of SD, incl. MAS
Methodological detailsPCT cut-off 0.5 ng/ml, univariate and multivariate analysis
- PCT cut-off 0.5 ng/ml
- Univariate and multivariate analysis
Main finding
As reported in the abstract
MAS risk by PCT elevation
Macrophage activation syndrome (MAS) risk, PCT ≥ 0.5 vs PCT < 0.5, univariate
6.4-fold
MAS risk, PCTmax ≥ 0.5 vs PCTmax < 0.5, univariate
7.6-fold
MAS risk, PCT ≥ 0.5 vs PCT < 0.5, multivariate
4.3-fold
MAS risk, PCTmax ≥ 0.5 vs PCTmax < 0.5, multivariate
5.4-fold
Observational data: associations, not effects.
Further findings
PCT levels vs controls
- PCT significantly higher in SD than HCs; nearly as elevated in MAS cases as in infection
Clinical features associated with elevated PCT
- MAS frequency, higher mPouchot scores and increased bDMARD use, particularly anakinra, associated with elevated PCT
Original publication
Clinical significance of non-infectious procalcitonin elevation in Still’s disease: a predictor of macrophage activation syndrome. Rheumatology (Oxford). Published 29 October 2025. doi:10.
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