Department of Pediatrics, Kagoshima University Hospital, 35-1 Sakuragaoka Kagoshimashi, Kagoshima, 890-8520, Japan.
Clin Rheumatol. 2019 Mar;38(3):835-840. doi: 10.1007/s10067-018-4359-9. Epub 2018 Nov 8.
Systemic juvenile idiopathic arthritis (sJIA) has recently become regarded as one of the autoinflammatory syndromes (AIS). However, other AIS, such as familial Mediterranean fever (FMF) and Blau syndrome, have been initially misdiagnosed as sJIA because of the clinical similarities. Making the correct diagnosis in the early stage of these AIS is desirable. Therefore, we evaluated serum S100A12 and vascular endothelial growth factor (VEGF) levels to determine if they could be biomarkers for differentiating these AIS.
Serum S100A12 and VEGF levels were examined in patients with Blau syndrome (n = 4), FMF (n = 4), and sJIA (n = 11) in the active and inactive phases.
In the active phase, S100A12 levels were significantly higher in patients with sJIA and FMF compared with those with Blau syndrome (p < 0.001). VEGF levels of patients with sJIA were significantly higher than those of patients with others (p = 0.001). In the inactive phase, there was no significant difference in VEGF levels. However, colchicine-resistant patients or patients without treatment with FMF showed high levels of S100A12 compared with others.
Measuring both serum S100A12 and VEGF levels may be useful for differentiating patients with Blau syndrome and FMF from those with sJIA at the early stage.
全身性幼年特发性关节炎(sJIA)最近被认为是自身炎症性疾病(AIS)之一。然而,由于临床相似性,其他 AIS,如家族性地中海热(FMF)和 Blau 综合征,最初被误诊为 sJIA。在这些 AIS 的早期做出正确的诊断是可取的。因此,我们评估了血清 S100A12 和血管内皮生长因子(VEGF)水平,以确定它们是否可以作为区分这些 AIS 的生物标志物。
在活动期和非活动期分别检测了 Blau 综合征(n=4)、FMF(n=4)和 sJIA(n=11)患者的血清 S100A12 和 VEGF 水平。
在活动期,sJIA 和 FMF 患者的 S100A12 水平明显高于 Blau 综合征患者(p<0.001)。sJIA 患者的 VEGF 水平明显高于其他患者(p=0.001)。在非活动期,VEGF 水平没有显著差异。然而,FMF 患者中无反应或未治疗的患者的 S100A12 水平较高。
同时测量血清 S100A12 和 VEGF 水平可能有助于在早期区分 Blau 综合征和 FMF 患者与 sJIA 患者。