Diagnostic accuracy of synovial fluid progranulin vs. C-reactive protein in septic arthritis: a comparative biomarker study.

IF 2.8 4区医学 Q3 RHEUMATOLOGY

Advances in Rheumatology Pub Date : 2026-06-27 DOI:10.1186/s42358-026-00559-7

Toktamış Savaş, İpek Koçer, Fatih Albayrak, Nurcihan Yavuz Savaş, Çağrı Karabulut, Bünyamin Kısacık

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引用次数: 0

Abstract

Background: Septic arthritis (SA) is a rapidly progressive joint disease that can lead to cartilage damage if not treated promptly. A prompt and accurate distinction between SA and inflammatory arthritis (IA) is essential for establishing an optimal treatment plan. Progranulin (PRGN), an anti-inflammatory glycoprotein involved in various autoimmune diseases, has rarely been studied as a diagnostic biomarker for infectious arthritis. However, its precise role in this context remains unclear. This study aimed to evaluate the diagnostic utility of synovial fluid PRGN (SF-PRGN) in distinguishing SA from IA and osteoarthritis (OA).

Methods: This single-center, cross-sectional study included 59 patients who underwent synovial fluid aspiration and were categorized into three groups: SA (n = 23), IA (n = 18), and OA (n = 18). SA was diagnosed based on a positive synovial fluid culture or fulfillment of clinical criteria suggestive of infection. SF-PRGN levels were measured using ELISA, and synovial fluid C-reactive protein (SF-CRP) levels were determined using an immunoturbidimetric assay.

Results: Mean SF-PRGN levels were higher in the SA (339.77 ± 142.16 ng/mL) and IA (300.52 ± 159.60 ng/mL) groups than in the OA group (133.44 ± 41.77 ng/mL), indicating a statistically significant difference between the inflammatory and non-inflammatory groups (p < 0.05). However, the SF-PRGN did not significantly differentiate between SA and IA (p = 0.803). In contrast, SF-CRP levels were markedly elevated in SA (61.91 ± 46.84 mg/L) and demonstrated strong discriminatory power between SA and IA (p < 0.001; AUC: 0.795, p < 0.0001).

Conclusion: Although SF-PRGN levels are elevated in inflammatory arthritis, they lack specificity for SA. SF-CRP exhibited superior diagnostic accuracy in differentiating SA from IA. These findings underscore the need for further research on reliable biomarkers of SA in larger patient cohorts.

Clinical trial registration: Clinical trial number not applicable.

查看原文本刊更多论文

滑膜液前颗粒蛋白与c反应蛋白在脓毒性关节炎中的诊断准确性：一项比较生物标志物研究

背景：脓毒性关节炎（SA）是一种快速进展的关节疾病，如果不及时治疗可导致软骨损伤。及时准确地区分SA和炎性关节炎（IA）对于制定最佳治疗方案至关重要。前颗粒蛋白（PRGN）是一种与多种自身免疫性疾病有关的抗炎糖蛋白，很少被研究作为感染性关节炎的诊断性生物标志物。然而，它在这方面的确切作用仍不清楚。本研究旨在评估滑液PRGN （SF-PRGN）在鉴别SA、IA和骨关节炎（OA）中的诊断价值。方法：这项单中心横断面研究纳入59例接受滑液抽吸的患者，分为三组：SA （n = 23）、IA （n = 18）和OA （n = 18）。SA的诊断是基于阳性的滑膜液培养或满足临床标准提示感染。采用ELISA法测定SF-PRGN水平，采用免疫比浊法测定滑液c反应蛋白（SF-CRP）水平。结果：SA组（339.77±142.16 ng/mL）和IA组（300.52±159.60 ng/mL）的SF-PRGN平均水平高于OA组（133.44±41.77 ng/mL），炎症组与非炎症组之间差异有统计学意义(p)结论：炎性关节炎中SF-PRGN水平升高，但对SA缺乏特异性。SF-CRP在鉴别SA和IA方面具有较高的诊断准确性。这些发现强调了在更大的患者群体中进一步研究可靠的SA生物标志物的必要性。临床试验注册：临床试验编号不适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Rheumatology Medicine-Rheumatology

CiteScore

4.00

自引率

4.30%

发文量

审稿时长

53 weeks

期刊介绍： Formerly named Revista Brasileira de Reumatologia, the journal is celebrating its 60th year of publication. Advances in Rheumatology is an international, open access journal publishing pre-clinical, translational and clinical studies on all aspects of paediatric and adult rheumatic diseases, including degenerative, inflammatory and autoimmune conditions. The journal is the official publication of the Brazilian Society of Rheumatology and welcomes original research (including systematic reviews and meta-analyses), literature reviews, guidelines and letters arising from published material.