Urinary free light chains may help to identify infection in patients with elevated systemic inflammation due to rheumatic disease

The risk of infection in patients with rheumatic diseases is elevated, but a clear marker to differentiate the cause of the systemic inflammation is missing. We assessed the ability urinary immunoglobulin free light chains (FLCs) to indicate the presence of infection in patients with rheumatic disea...

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Bibliographic Details
Published in:Rheumatology international 2017-04, Vol.37 (4), p.599-605
Main Authors: Bramlage, Carsten P., Froelich, Britta, Wallbach, Manuel, Minguet, Joan, Grupp, Clemens, Deutsch, Cornelia, Bramlage, Peter, Müller, Gerhard A., Koziolek, Michael
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biomarkers
Biomarkers - urine
Female
Humans
Immunoglobulin Light Chains - urine
Infection - complications
Infection - diagnosis
Infection - urine
Inflammation - complications
Inflammation - urine
Male
Medicine
Medicine & Public Health
Middle Aged
Retrospective Studies
Rheumatic Diseases - complications
Rheumatic Diseases - urine
Rheumatology
Sensitivity and Specificity
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Summary:The risk of infection in patients with rheumatic diseases is elevated, but a clear marker to differentiate the cause of the systemic inflammation is missing. We assessed the ability urinary immunoglobulin free light chains (FLCs) to indicate the presence of infection in patients with rheumatic disease. We performed a retrospective analysis of patients with rheumatic disease attending the Georg-August University Hospital in Goettingen, Germany, from January 2011 to December 2013. Subjects were included if they had urine levels of κ and λ FLCs available. A reference group of patients without autoimmune disease, but with documented infection, was constructed. A total of 1500 patients had their urinary FLCs quantified during the study period. Of the 382 patients with rheumatic disease, 172 (45%) displayed no systemic inflammation, 162 (42%) had inflammation due to the underlying disease activity, and 48 (13%) had inflammation due to a confirmed infection. Urinary FLC concentrations were much higher in patients with rheumatic diseases and infection ( κ 68.8 ± 81.8 mg/L, λ 31.4 ± 53.5 mg/L) compared to those with inflammation due to rheumatic disease activity ( κ 22.7 ± 26.3 mg/L, λ 8.1 ± 9.1 mg/L, κ p  
ISSN:0172-8172
1437-160X
DOI:10.1007/s00296-017-3666-9