Ferritin and C-reactive protein are predictive biomarkers of mortality and macrophage activation syndrome in adult onset Still's disease. Analysis of the multicentre Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2020
Historique:
received: 31 03 2020
accepted: 14 06 2020
entrez: 10 7 2020
pubmed: 10 7 2020
medline: 10 9 2020
Statut: epublish

Résumé

To assess the predictive role of ferritin and C-reactive protein (CRP) on occurrence of macrophage activation syndrome (MAS) and mortality in patients with adult onset Still's disease (AOSD), a rare and severe disease, included in the multicentre Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort. The predictive role, at the time of diagnosis, of serum levels of ferritin and CRP on occurrence of MAS and mortality, was evaluated by logistic regression analyses and receiver-operating characteristic (ROC) curves were built to identify patients at high risk of MAS and mortality, respectively. In assessed 147 patients with AOSD, levels of ferritin were predictive of MAS (OR: 1.971; P: 0.002; CI 95%: 1.280-3.035). The ROC curve showed that the best cut-off for ferritin was 1225 ng/ml in predicting MAS (sensitivity 88%; specificity 57%). Levels of CRP were predictive of mortality in these patients (OR: 2.155; P: 0.007; CI 95%: 1.228-3.783). The ROC curve showed that the best cut-off for CRP was 68.7 mg/L in predicting mortality (sensitivity 80%; specificity of 65%). We reported the predictive role of ferritin and CRP on MAS and mortality, respectively, in a large cohort of patients with AOSD, identifying subsets at higher risk of poor prognosis. Considering that the analysis of CRP and ferritin is widely available, these results could be readily transferable into clinical practice, thus improving the management of patients with AOSD.

Identifiants

pubmed: 32645077
doi: 10.1371/journal.pone.0235326
pii: PONE-D-20-09182
pmc: PMC7347102
doi:

Substances chimiques

Biomarkers 0
C-Reactive Protein 9007-41-4
Ferritins 9007-73-2

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0235326

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Paola Di Benedetto (P)

Clinical Pathology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.

Paola Cipriani (P)

Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.

Daniela Iacono (D)

Rheumatology Section, Department of Clinical and Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.

Ilenia Pantano (I)

Rheumatology Section, Department of Clinical and Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.

Francesco Caso (F)

Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy.

Giacomo Emmi (G)

Department of Experimental and Clinical Medicine, University of Firenze, Florence, Italy.

Rosa Daniela Grembiale (RD)

Department of Health Sciences, University of Catanzaro "Magna Graecia"; Catanzaro, Italy.

Francesco Paolo Cantatore (FP)

Rheumatology Unit, Department of Medical and Surgery Sciences, University of Foggia, Foggia, Italy.

Fabiola Atzeni (F)

Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

Federico Perosa (F)

Rheumatic and Systemic Autoimmune Diseases Unit, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy.

Raffaele Scarpa (R)

Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy.

Giuliana Guggino (G)

Rheumatology Section, Department of Internal Medicine, University of Palermo, Palermo, Italy.

Francesco Ciccia (F)

Rheumatology Section, Department of Clinical and Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.

Roberto Giacomelli (R)

Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.

Piero Ruscitti (P)

Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.

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