title: [The clinical significance of serum neopterin and adenosine deaminase in patients with secondary hemophagocytic lymphohistiocytosis].
abstract: OBJECTIVE
  To investigate the significance of plasma neopterin (Npt) and adenosine deaminase (ADA) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).
  
  
  METHODS
  Serum specimens from 39 patients with newly diagnosed sHLH, 10 sHLH patients who had achieved clinical remission after treatment, and 15 healthy controls were collected.Serum Npt level was detected by enzyme linked immunosorbent assay (ELISA) and ADA activity was tested by kinetic method.
  
  
  RESULTS
  Npt and ADA values in sHLH group were significantly higher than those in control group [Npt: (164.6 ± 90.0) nmol/L vs (7.9 ± 3.6) nmol/L;ADA: (117.2 ± 70.2) U/L vs (11.6 ± 4.0) U/L;all P < 0.001]. Among the 10 sHLH patients who obtained effective clinical treatment, posttreatment levels of Npt and ADA were significantly lower than pretreatment data [Npt: (17.5 ± 10.9) nmol/L vs (170.6 ± 117.9) nmol/L;ADA: (22.5 ± 15.5) U/L vs (98.8 ± 52.6) U/L;all P < 0.05]. The Npt level in sHLH patients was positively correlated with the levels of serum soluble interleukin-2 receptor (sCD25) and serum ferritin (r = 0.526 and r = 0.507) ; while ADA activity had linear relationship with the level of lactate dehydrogenase (r = 0.646) .Receiver operating characteristic (ROC) curve analysis showed that 148.1 nmol/L was the critical value of serum Npt for the diagnosis of lymphoma associated hemophagocytic syndrome (LAHS) and the sensitivity and specificity were 70.0% and 78.9%, respectively. As to ADA, 103.1 U/L was the critical value for the diagnosis of LAHS and the sensitivity and specificity were 75.0% and 84.2%, respectively. The sensitivity and specificity of combined parameters of Npt and ADA were 90.0% and 94.7%, respectively.
  
  
  CONCLUSIONS
  It is concluded that Npt and ADA have great importance in the diagnosis and evaluation of therapeutic effect in patients with sHLH.Npt and ADA provide potential evidence to diagnose patients who are suspected with LAHS.
authors: Weifeng
authors: W
authors: Chen
authors: Department of Hematology, First Hospital of Nanjing Medical University, Jiangsu Provincial Hospital, Nanjing 210029, China. Email: qhx9805@126.com.
authors: Hongxia
authors: H
authors: Qiu
authors: Xiangchou
authors: X
authors: Yang
authors: Wei
authors: W
authors: Zhang
authors: Sujiang
authors: S
authors: Zhang
authors: Xiaoyan
authors: X
authors: Zhang
authors: Jianyong
authors: J
authors: Li
mesh_terms: D000243:Adenosine Deaminase / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000097:blood / Q000175:diagnosis*; D008223:Lymphoma; D019798:Neopterin / Q000097:blood*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D019798:Neopterin; D000243:Adenosine Deaminase