Role of mean platelet volume in differential diagnosis of adult-onset Still's disease and sepsis

Abstract

OBJECTIVES: Mean platelet volume is a simple biomarker for inflammatory disease. The purpose of this study is to evaluate the role of mean platelet volume in distinguishing adult-onset Still's disease from sepsis. METHODS:We retrospectively selected 68 patients with adult-onset Still's disease and 55 patients with sepsis between January 2015 and December 2019. Related laboratory data were collected and analyzed.RESULTS: There were no significant differences in white blood cell counts, neutrophils, lymphocytes, and C-reactive protein between adult-onset Still's disease group and sepsis group. However, patients in adult-onset Still's disease group showed higher ferritin and platelets and lower mean platelet volume and platelet distribution width than those in sepsis group (p<0.01 for both). Receiver operating characteristic curve analysis was performed to distinguish adult-onset Still's disease and sepsis. The area under the curve of mean platelet volume was 0.761 (95%CI 0.673-0.849), with a sensitivity of 79.1%, a specificity of 63.3%, and a cutoff value of 10.9 fL.In contrast, the area under the curve of combined ferritin and mean platelet volume was 0.90l (95%CI 0.837-0.965), with higher sensitivity (82.8%) and specificity (96.2%). Therefore, mean platelet volume could be used as a supplementary indicator to distinguish adult-onset Still's disease from sepsis. CONCLUSION:We suggest that mean platelet volume could be used as a supplementary biomarker for differential diagnosis of adultonset Still's disease and sepsis in addition to ferritin.

Role of mean platelet volume in differential diagnosis of adult-onset Still's disease and sepsis

“…After a search of the databases, screening of results, and review of reference lists and citations, a total of five studies met selection criteria 1,[6][7][8][9] (see Table 1). The studies were conducted in China (four studies) 1,6,7,9 and Turkey (one 8 . The studies included data on 412 AOSD patients, with sample sizes varying between 61 and 110 subjects.…”

“…Luo and colleagues have recently published a study entitled “Role of mean platelet volume in differential diagnosis of adult-onset Still's disease and sepsis” in Revista da Associação Médica Brasileira examining the role of mean platelet volume (MPV) to distinguish adult-onset Still's disease (AOSD) from sepsis 1 . This is a potentially impactful article, since AOSD can be difficult to distinguish from sepsis and other reactive conditions.…”

“…After a search of the databases, screening of results, and review of reference lists and citations, a total of five studies met selection criteria 1 , 6 − 9 (see Table 1 ). The studies were conducted in China (four studies) 1 , 6 , 7 , 9 and Turkey (one study) 8 .…”

“…The studies included data on 412 AOSD patients, with sample sizes varying between 61 and 110 subjects. The control populations included 337 patients with clinical features resembling AOSD, including sepsis (3 studies) 1 , 6 , 7 , fibromyalgia syndrome (1 study) 8 , and fever of unknown origin (1 study) 9 . A total of 157 healthy control subjects were included in two studies 7 , 9 .…”

“…A total of 157 healthy control subjects were included in two studies 7 , 9 . Four studies used CBCs performed on the Sysmex SE analyzer (Kobe, Japan) 1 , 6 , 7 , 9 ; for the remaining study, the blood analyzer was not identified 8 . The standardized mean difference (SMD) for five studies is shown in Figure 1 .…”