Abstract Twelve


Serum ferritin and isoferritins are tools for diagnosis of active adult Still's disease.

Van Reeth C  Le Moel G  Lasne Y  
 Revenant MC  Agneray J  Kahn MF  
 Bourgeois P  

In: J Rheumatol (1994 May) 21(5):890-5

ISSN: 0315-162X

OBJECTIVE. Still's disease is an acute systemic inflammatory  disorder. There are no pathognomonic symptoms or specific laboratory  abnormalities. Serum ferritin concentration in rheumatoid arthritis
 together with some plasma glycoproteins such as alpha 2-glycoprotein  and C-reactive protein are part of the response to inflammation.

Ferritin in plasma is glycosylated and the sialoglycosylated forms  increase its microheterogeneity. Our purpose was to confirm in a  large series that high values of ferritin can be found in adult  Still's disease (ASD) and to see if a specific isoferritin can be
 isolated in this disease compared with the other systemic diseases.

METHOD. Thirty-one sera were investigated from 11 men and 9 women  with ASD and compared with 27 sera from 27 patients with systemic  diseases. We studied the course of one case of ASD for 15 months.  Serum ferritin was determined by immunoenzymology (Abbott Ferrizin).  The isoferritins were investigated by isoelectric focussing and the
 percentage of glycosylation by affinity for concanavalin A (Con-A).

 RESULTS. In patients with active ASD, the ferritin levels were higher
 than in patients with inactive ASD or other systemic diseases: p <
 0.001. The glycoforms of ferritin were basic and the proportion of
 ferritin bound to Con-A was lower than other ASD: p < 0.001.

 CONCLUSIONS. Serum ferritin levels have a diagnostic value for acute  ASD. The study of sialylation and abnormalities in the glycosylation  of ferritin helps to discriminate ASD from arthritis or other  systemic diseases. In conclusion, the glycoform of isoferritins and
 the percentage of glycosylation offers an additional tool for the  diagnosis of Still's disease.

Registry Numbers: 9007-73-2 (Ferritin)

Institutional address:
       Rheumatology Department
       Pitie Hospital

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