CRP and sCD25 help distinguish between adult‐onset Still's disease and HLH
Rattachement africain : ca, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
OBJECTIVE: Adult-onset Still's disease (AOSD) and secondary hemophagocytic lymphohistiocytosis (sHLH) are both hyperferritinemic cytokine storm syndromes that can be difficult to distinguish from each other in hospitalized patients. The objective of this study was to compare the inflammatory markers ferritin, D-dimer, C-reactive protein (CRP), and soluble CD25 (sCD25) in patients with AOSD and sHLH. These four markers were chosen as they are widely available and represent different aspects of inflammatory diseases: macrophage activation (ferritin); endothelialopathy (D-dimer); interleukin-1/interleukin-6/tumour necrosis factor elevation (CRP) and T cell activation (sCD25). METHODS: This was a single-center retrospective study. Patients diagnosed by the Hematology service at Vancouver General Hospital for AOSD or sHLH from 2009 to 2023 were included. RESULTS: There were 16 AOSD and 44 sHLH patients identified. Ferritin was lower in AOSD than HLH (median 11 360 μg/L vs. 29 020 μg/L, p = .01) while D-dimer was not significantly different (median 5310 mg/L FEU vs. 7000 mg/L FEU, p = .3). CRP was higher (median 168 mg/L vs. 71 mg/L, p <.01) and sCD25 was lower (median 2220 vs. 7280 U/mL, p = .004) in AOSD compared to HLH. The combined ROC curve using CRP >130 mg/L and sCD25< 3900 U/mL to distinguish AOSD from HLH had an area under the curve (AUC) of 0.94 (95% confidence interval 0.93-0.97) with sensitivity 91% and specificity 93%. CONCLUSIONS: These findings suggest that simple, widely available laboratory tests such as CRP and sCD25 can help clinicians distinguish AOSD from HLH in acutely ill adults with extreme hyperferritinemia. Larger studies examining a wider range of clinically available inflammatory biomarkers in a more diverse set of cytokine storm syndromes are warranted.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé, mais le titre doit être comparé manuellement.
- Titre Crossref
- <scp>CRP</scp> and <scp>sCD25</scp> help distinguish between adult‐onset Still's disease and <scp>HLH</scp>
- Date Crossref
- 10/07/2024
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of British Columbia Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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BC Children's Hospital pays non établi dans la noticeÉtablissement de santé
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St. Paul's Hospital pays non établi dans la noticeÉtablissement de santé
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University of Pennsylvania Center for Cytokine Storm Treatment & pays non établi dans la noticeUniversité ou école supérieure
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Dalhousie University Division of Hematology pays non établi dans la noticeUniversité ou école supérieure
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Division of Hematopathology British Columbia Children's Hospital Vancouver Canada Division of Hematopathology pays non établi dans la noticeÉtablissement de santé
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Department of Pathology and Laboratory Medicine pays non établi dans la noticeStructure de recherche
Department of Medicine — University of British Columbia, BC Children's Hospital et St. Paul's Hospital, avec 4 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.