High ferritin and low glycosylated ferritin may also be a marker of excessive macrophage activation

OBJECTIVE: A high serum ferritin concentration with a low percentage of glycosylated ferritin (< 20%) have been reported to be a specific marker of active adult Still's disease (ASD). However, high ferritin levels are found during hemophagocytosis syndrome (HS). We investigated the ferritin...

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Published in:Journal of rheumatology 2003-05, Vol.30 (5), p.1027-1028
Main Authors: LAMBOTTE, Olivier, CACOUB, Patrice, COSTEDOAT, Nathalie, LE MOEL, Gisele, AMOURA, Zahir, PIETTE, Jean-Charles
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Biomarkers
C-Reactive Protein - metabolism
Female
Ferritins - analogs & derivatives
Ferritins - blood
Glycosylation
Hematologic and hematopoietic diseases
Histiocytosis, Non-Langerhans-Cell - diagnosis
Histiocytosis, Non-Langerhans-Cell - immunology
Histiocytosis, Non-Langerhans-Cell - metabolism
Humans
Macrophages - immunology
Macrophages - metabolism
Male
Medical sciences
Middle Aged
Other diseases. Hematologic involvement in other diseases
Phagocytosis - immunology
Sensitivity and Specificity
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Summary:OBJECTIVE: A high serum ferritin concentration with a low percentage of glycosylated ferritin (< 20%) have been reported to be a specific marker of active adult Still's disease (ASD). However, high ferritin levels are found during hemophagocytosis syndrome (HS). We investigated the ferritin level and the percentage of glycosylation in a HS series of various causes. METHODS: Diagnosis of HS was confirmed by erythrophagocytosis pictures on a bone marrow cytology or biopsy in all patients. Serum ferritin concentration was determined on a heterogenous immunoassay module. Glycosylated ferritin was separated using concanavalin A (Con-A) sepharose 4B chromatography. The nonglycosylated ferritin unbound to Con-A was recovered in the supernatant and quantified with the same procedure. Percentages of glycosylated ferritin less than 20% are considered to be usual in ASD, between 20 and 40% usual in inflammatory syndrome, and between 50 and 80% normal. RESULTS: In all cases tested during the acute phase of the disease, ferritin blood level was high and the percentage of glycosylated ferritin was low, less than 20%. CONCLUSION: The combination of high ferritin level and low percentage of glycosylation may be a marker of excessive macrophage activation.
ISSN:0315-162X
1499-2752