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
In: J Rheumatol (1994 May) 21(5):890-5
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)