title: Serum HO-1 is useful to make differential diagnosis of secondary hemophagocytic syndrome from other similar hematological conditions.
abstract: Heme oxygenase (HO)-1, a heme-degrading enzyme inducible by various stimuli, plays a key role in the regulation of inflammatory response in monocytes/macrophages. The serum HO-1 level is remarkably increased in patients with secondary hemophagocytic syndrome (HPS) or adult-onset Still's disease. We measured serum HO-1 levels in patients with a variety of hematological diseases, including secondary HPS, by means of ELISA. Serum HO-1 levels were significantly higher in 22 patients with HPS (134.7 +/- 116.2 ng/mL, P < 0.0001) at diagnosis than in 80 patients with other hematological diseases. The most effective cutoff point between HPS and other conditions was 14.5 ng/mL, with 100.0% sensitivity and 96.3% specificity. In HPS patients, the serum HO-1 levels showed the highest correlation with serum ferritin (r = 0.682, P = 0.0005), which reflects the disease activity of HPS. Moreover, both HO-1 and ferritin levels were reduced in parallel after successful treatment in patients with HPS, irrespective of underlying diseases. However, HO-1 levels were not elevated in patients with other causes of hyperferritinemia. These data demonstrate that serum HO-1 can distinguish secondary HPS from other hematological diseases, including those associated with hyperferritinemia.
authors.affiliation: Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kirino
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takeno
authors.forename: Maasa
authors.initials: M
authors.lastname: Hama
authors.forename: Ayumi
authors.initials: A
authors.lastname: Ushihama
authors.forename: Reina
authors.initials: R
authors.lastname: Watanabe
authors.forename: Kaoru
authors.initials: K
authors.lastname: Takase
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tachibana
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Tanaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamaji
authors.forename: Haruko
authors.initials: H
authors.lastname: Ideguchi
authors.forename: Naoto
authors.initials: N
authors.lastname: Tomita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujita
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ohno
authors.forename: Atsuhisa
authors.initials: A
authors.lastname: Ueda
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ishigatsubo
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005293:Ferritins / Q000097:blood; D051547:Heme Oxygenase-1 / Q000097:blood*; D006801:Humans; D019189:Iron Metabolism Disorders / Q000097:blood / Q000175:diagnosis*; D051359:Lymphohistiocytosis, Hemophagocytic / Q000097:blood* / Q000175:diagnosis*; D008264:Macrophages / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005293:Ferritins; D051547:Heme Oxygenase-1