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Guerber A, Garneret E, El Jammal T, Zaepfel S, Gerfaud-Valentin M, Sève P, Jamilloux Y. Evaluation of Glycosylated Ferritin in Adult-Onset Still's Disease and Differential Diagnoses. J Clin Med 2022; 11:jcm11175012. [PMID: 36078942 PMCID: PMC9456550 DOI: 10.3390/jcm11175012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Glycosylated ferritin (GF) has been reported as a good diagnostic biomarker for adult-onset Still’s disease (AOSD), but only a few studies have validated its performance. We performed a retrospective study of all adult patients with at least one GF measurement over a 2-year period in one hospital laboratory. The diagnosis of AOSD was based on the expert opinion of the treating physician and validated by two independent investigators. Patients’ characteristics, disease activity, and outcome were recorded and compared. Twenty-eight AOSD and 203 controls were identified. Compared to controls, the mean GF was significantly lower (22.3% vs. 39.3, p < 0.001) in AOSD patients. GF had a high diagnostic accuracy for AOSD, independent of disease activity or total serum ferritin (AUC: 0.674 to 0.915). The GF optimal cut-off value for AOSD diagnosis was 16%, yielding a specificity of 89% and a sensitivity of 63%. We propose a modified diagnostic score for AOSD, based on Fautrel’s criteria but with a GF threshold of 16% that provides greater specificity and increases the positive predictive value by nearly 5 points. GF is useful for ruling out differential diagnoses and as an appropriate classification criterion for use in AOSD clinical trials.
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Affiliation(s)
- Arthur Guerber
- Internal Medicine, University Hospital Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
- Faculty of Medicine, Claude Bernard University Lyon 1, 69622 Villeurbanne, France
- Correspondence: (A.G.); (Y.J.); Tel.: +33-426-732-636 (Y.J.)
| | - Etienne Garneret
- Internal Medicine, University Hospital Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
- Faculty of Medicine, Claude Bernard University Lyon 1, 69622 Villeurbanne, France
| | - Thomas El Jammal
- Internal Medicine, University Hospital Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Sabine Zaepfel
- Biochemistry Department, University Hospital Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Mathieu Gerfaud-Valentin
- Internal Medicine, University Hospital Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Pascal Sève
- Internal Medicine, University Hospital Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, 69373 Lyon, France
| | - Yvan Jamilloux
- Internal Medicine, University Hospital Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
- Lyon Immunopathology Federation (LIFE), 69000 Lyon, France
- Correspondence: (A.G.); (Y.J.); Tel.: +33-426-732-636 (Y.J.)
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Raynor A, Peoc'h K, Boutten A. Measurement of glycosylated ferritin with Concanavalin A: Assay design, optimization and validation. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1194:123184. [DOI: 10.1016/j.jchromb.2022.123184] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 11/25/2022]
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Abstract
Adult onset Still's disease (AOSD) with an incidence of 1-3 cases per 1 million belongs to the most difficult diagnosis of febrile diseases. The lack of biomarkers and its similarity to infectious and malignant and rheumatic diseases lead to a prolongation of its diagnosis. The following report focuses on providing an overview of the current knowledge of relevant symptoms and laboratory parameters for the diagnosis of AOSD and new treatment possibilities.
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Affiliation(s)
- N T Baerlecken
- Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Deutschland.
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Abstract
Alteration in iron metabolism is one of the proposed mechanisms underlying the anaemia of inflammation and chronic disease, the most common disorder in hospitalized patients. Iron metabolism parameters in inflammatory disease are characterized by blockage of tissue iron release, decreased serum iron and total iron binding capacity and an elevated serum ferritin level, reflecting augmented ferritin synthesis as part of the acute-phase response. The altered iron metabolism in inflammation is proposed to be a part of the host defence mechanism against invading pathogens and tumor cells and is suggested to be mediated by inflammatory cytokines and NO.
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Affiliation(s)
- A M Konijn
- Department of Human Nutrition and Metabolism, Faculty of Medicine, Hebrew University, Jerusalem, Israel
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