Document Detail

Increased ferritin response in adult Still's disease: specificity and relationship to outcome.
MedLine Citation:
PMID:  17476616     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The disproportionate ferritin response encountered in some patients with adult Still's disease (ASD) may reflect a fundamental aspect in the pathophysiology of ASD. METHODS: An observational case-control study of 22 ASD patients followed for 63 months. Baseline laboratory data were compared with age- and gender-matched controls with new-onset rheumatoid arthritis (RA). Serum levels of ferritin and C-reactive protein (CRP) and the ferritin/CRP ratio were related to clinical outcome in ASD through nonparametric statistical analyses. RESULTS: Compared to RA patients, haemoglobin levels were lower (11.8 vs. 13.5 g/dL; p = 0.009) and leucocyte counts (17.1 vs. 8.6 10(9)/mL; p<0.001), erythrocyte sedimentation rate (ESR) (84 vs. 38 mm; p = 0.001), CRP (154 vs. 27 mg/L; p<0.001), aspartate aminotransferase (ASAT) (52 vs. 23 U/l; p = 0.004), serum ferritin (8750 vs. 62 microg/L; p<0.001) and ferritin/CRP ratios (9.7 vs. 1.7; p<0.001) were higher in ASD patients at baseline. Six patients (27%) achieved sustained remission (monocyclic disease), while 16 patients (73%) developed chronic disease (progressive in 27%, relapsing/remitting in 46%). The levels of ESR and CRP or other baseline variables were not associated with outcome. However, baseline serum ferritin was significantly higher in ASD patients with chronic disease (p = 0.04), while a cut-off of five times the normal upper level (NUL) was 100% sensitive and 60% specific for predicting chronic disease. CONCLUSION: An exaggerated ferritin response with levels>5 times the NUL and high ferritin/CRP ratios is useful for distinguishing between ASD and RA patients. Ferritin levels>5 times the NUL are also associated with a chronic disease course.
K J Evensen; T J G Swaak; J C Nossent
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of rheumatology     Volume:  36     ISSN:  0300-9742     ISO Abbreviation:  Scand. J. Rheumatol.     Publication Date:    2007 Mar-Apr
Date Detail:
Created Date:  2007-05-03     Completed Date:  2007-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0321213     Medline TA:  Scand J Rheumatol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  107-10     Citation Subset:  IM    
Department of Rheumatology, Institute of Clinical Medicine, University of Tromsø, Norway.
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MeSH Terms
Biological Markers
C-Reactive Protein / analysis*
Case-Control Studies
Ferritins / blood*,  immunology
Follow-Up Studies
Inflammation / immunology
Middle Aged
Still's Disease, Adult-Onset / blood*,  diagnosis
Reg. No./Substance:
0/Biological Markers; 9007-41-4/C-Reactive Protein; 9007-73-2/Ferritins

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