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Evaluation of Glycosylated Ferritin in Adult-Onset Still’s Disease and Differential Diagnoses

Title: Evaluation of Glycosylated Ferritin in Adult-Onset Still’s Disease and Differential Diagnoses
Authors: Arthur Guerber; Etienne Garneret; Thomas El Jammal; Sabine Zaepfel; Mathieu Gerfaud-Valentin; Pascal Sève; Yvan Jamilloux
Source: Journal of Clinical Medicine ; Volume 11 ; Issue 17 ; Pages: 5012
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2022
Collection: MDPI Open Access Publishing
Subject Terms: glycosylated ferritin; adult-onset Still’s disease; diagnostic accuracy; hemophagocytic lympho-histiocytosis
Description: 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.
Document Type: text
File Description: application/pdf
Language: English
Relation: Immunology & Rheumatology; https://dx.doi.org/10.3390/jcm11175012
DOI: 10.3390/jcm11175012
Availability: https://doi.org/10.3390/jcm11175012
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.60829BEC
Database: BASE