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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
       Paris
       France.