Vignes S, Le Moël G, Fautrel B, Wechsler B, Godeau P, Piette J C
Service de Médecine Interne, Hôpital de la Pitié-Salpêtrière, Paris, France.
Ann Rheum Dis. 2000 May;59(5):347-50. doi: 10.1136/ard.59.5.347.
To determine the evolution of levels of total serum ferritin and percentage of the glycosylated form in patients with adult onset Still's disease (AOSD) at the time of diagnosis and during follow up.
All patients with AOSD were tested at the time of diagnosis and during follow up. Total serum ferritin levels were analysed by immunoassay, and the percentage of glycosylated ferritin was determined by methods using Sepharose-Con A.
14 patients (eight women, six men) with AOSD were enrolled. At the time of diagnosis, mean (SD) age was 36 (16) years. Mean initial total serum ferritin was 6350 (1300) microg/l (normal <250 microg/l). The mean initial percentage of glycosylated ferritin was 14.7 (13)% (normal >50%). Mean follow up time was 37 (35) months. At the time of the last examination all patients were in remission except one, who presented a chronic articular form. Total serum ferritin remained high in this single patient and was normal in the 13 others, with a mean of 98 (73) microg/l. In all patients the percentage of glycosylated ferritin remained low, with a mean of 16 (16)%.
Total serum ferritin is a marker of the active phase of AOSD. The percentage of glycosylated ferritin is low both in the active phase and in remission. Further studies are needed to confirm these data and to determine their specificity for AOSD before considering any possible use of a low percentage of glycosylated ferritin as a diagnostic tool in suspected AOSD, especially when atypical or previously treated.
确定成人斯蒂尔病(AOSD)患者在诊断时及随访期间血清总铁蛋白水平和糖基化形式百分比的变化情况。
对所有AOSD患者在诊断时及随访期间进行检测。采用免疫测定法分析血清总铁蛋白水平,使用琼脂糖-伴刀豆球蛋白A法测定糖基化铁蛋白的百分比。
纳入14例AOSD患者(8例女性,6例男性)。诊断时,平均(标准差)年龄为36(16)岁。初始血清总铁蛋白平均为6350(1300)μg/l(正常<250μg/l)。糖基化铁蛋白的初始平均百分比为14.7(13)%(正常>50%)。平均随访时间为37(35)个月。在最后一次检查时,除1例呈现慢性关节型的患者外,所有患者均处于缓解期。该例患者血清总铁蛋白仍高,其他13例患者正常,平均为98(73)μg/l。所有患者糖基化铁蛋白百分比均较低,平均为16(16)%。
血清总铁蛋白是AOSD活动期的标志物。糖基化铁蛋白百分比在活动期和缓解期均较低。在考虑将低百分比的糖基化铁蛋白作为疑似AOSD的诊断工具(尤其是非典型或曾接受治疗的情况)之前,需要进一步研究以证实这些数据并确定其对AOSD的特异性。