The mid-range of the adjusted level of ferritin can predict the chronic course in patients with adult onset Still's disease.
OBJECTIVE
To find a measure that can predict the disease course in patients with adult onset Still's disease (AOSD).


METHODS
We retrospectively investigated the medical records of 71 hospitalized patients with AOSD. Patients were divided according to chronic and nonchronic disease course. The initial laboratory results were defined as those at the time of admission, the extremely deviated laboratory results as the highest or the lowest results, and the adjusted laboratory results as area under the curve divided by the days of hospitalization. All measures were compared and the odds ratio (OR) for the chronic disease pattern was assessed.


RESULTS
The mean age was 39.7+/-13.5 years and women accounted for 63 of the total 71 (88.7%). Thirty patients (42.3%) had self-limited disease, 9 (12.7%) intermittent disease, and 23 (32.4%) the chronic disease pattern (32.4%). Nine patients (12.7%) died. The initial levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and ferritin, the highest levels of lactate dehydrogenase (LDH) and ferritin, and the adjusted level of ferritin in patients with chronic disease were significantly higher than those with nonchronic disease. Among them, only the middle range of the adjusted ferritin level (784.1-4120.0 ng/ml) was found to have a significant predictive value for the chronic disease pattern (OR 81.7, p=0.007).


CONCLUSIONS
A novel measure, the adjusted level of ferritin during the first hospitalization, might be useful to predict progression to chronic disease in patients with AOSD.
Lee
Sang-Won
SW
Department of Rheumatology, Chung-Ang University College of Medicine, Seoul, Korea.
Park
Yong-Beom
YB
Song
Jung-Soo
JS
Lee
Soo-Kon
SK
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001706:Biopsy; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016706:Still's Disease, Adult-Onset / Q000097:blood* / Q000473:pathology* / Q000628:therapy; D016896:Treatment Outcome
D015415:Biomarkers; D005293:Ferritins