Diagnostic value of serum ferritin in systemic juvenile idiopathic arthritis with macrophage activation syndrome / 中华实用儿科临床杂志

ABSTRACT

Obj ective To determine the value of serum ferrifin (SF) in diagnosing systemic juvenile idiopathic arthritis (sJIA) with macrophage activation syndrome(MAS).Methods In this study,40 patients with sJIA at the First Affiliated Hospital of Kunming Medical University from December 2012 to December 2015 were divided into 2 groupssJIA group and sJIA with MAS group,while 20 patients with acute fever at the First Affiliated Hospital of Kunming Medical College were selected as a control group.Before and after treatment,SF was measured with radioimmunological method in 3 groups.Statistical analysis was made by undertaking SPSS 18.0 software.Thedata obtained were analyzed by variance,comparison between groups was made by t-test,and the comparison among groups of enumeration data was tested by chi-square.The differences among groups were considered significant (P ＜ 0.05).Results The levels of SF before treatment in the sJIA group,the sJIA with MAS group and the control group were (2 413.50 ±606.73) μg/L,(7 052.77 ± 2 828.43) μg/L and (135.05 ±32.75) μg/L,respectively.The levels of SF in sJIA group and sJIA with MAS group were proved to be greater than those of the control group (F =92.63,P ＜ 0.01).The level of SF in sJIA with MAS group was significantly higher than that of the sJIA group,and the difference between 2 groups was statistically significant (t =9.19,P ＜ 0.01).The level of SF for 95％ patients in sJIA group was ≤4 000 μg/L.The level of SF of 83％ patients in So-JRA with MAS group was ＞4 000 μg/L,and there was a significance between 2 groups(x2 =25.61,P ＜ 0.01).If the criteria of diagnosis of sJIA with MAS was SF above 4 000 μg/L,the sensitivity was 83.33％,specificity was 95.45％,positive predictive value was 93.75％ and negative predictive value was 87.50％.The level of SF after treatment in sJIA group and sJIA with MAS group [(228.40 ± 78.02) μg/L and (259.55 ± 86.46) μg/L] were lower than that before treatment (t =16.53,10.02,all P ＜ 0.01).Conclusions The levels of SF can be abnormally elevated in cases of sJIA with MAS.Taking the SF above 4 000 μg/L as a criteria of diagnosis of sJIA with MAS would contribute to the early diagnosis and reduction of mortality in sJIA patientswith MAS.