High ferritin and low glycosylated ferritin may also be a marker of excessive macrophage activation.
OBJECTIVE
A high serum ferritin concentration with a low percentage of glycosylated ferritin (< 20%) have been reported to be a specific marker of active adult Still's disease (ASD). However, high ferritin levels are found during hemophagocytosis syndrome (HS). We investigated the ferritin level and the percentage of glycosylation in a HS series of various causes.


METHODS
Diagnosis of HS was confirmed by erythrophagocytosis pictures on a bone marrow cytology or biopsy in all patients. Serum ferritin concentration was determined on a heterogenous immunoassay module. Glycosylated ferritin was separated using concanavalin A (Con-A) sepharose 4B chromatography. The nonglycosylated ferritin unbound to Con-A was recovered in the supernatant and quantified with the same procedure. Percentages of glycosylated ferritin less than 20% are considered to be usual in ASD, between 20 and 40% usual in inflammatory syndrome, and between 50 and 80% normal.


RESULTS
In all cases tested during the acute phase of the disease, ferritin blood level was high and the percentage of glycosylated ferritin was low, less than 20%.


CONCLUSIONS
The combination of high ferritin level and low percentage of glycosylation may be a marker of excessive macrophage activation.
Department of Internal Medicine, Groupe Hospitalier Pitié, Paris, France.
Olivier
O
Lambotte
Patrice
P
Cacoub
Nathalie
N
Costedoat
Gisele
G
Le Moel
Zahir
Z
Amoura
Jean-Charles
JC
Piette
D000328:Adult; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005293:Ferritins / Q000031:analogs & derivatives* / Q000097:blood*; D006031:Glycosylation; D015616:Histiocytosis, Non-Langerhans-Cell / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D008264:Macrophages / Q000276:immunology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010587:Phagocytosis / Q000276:immunology; D012680:Sensitivity and Specificity; D006023:Glycoproteins
D015415:Biomarkers; D002097:C-Reactive Protein; D005293:Ferritins; C051036:glycosylated ferritin; D006023:Glycoproteins