Combination value of biomarkers in discriminating adult onset Still’s disease and sepsis

Zhang, Mingjie; Xie, Mengxiao; Wang, Yaman; Li, Jie; Zhou, Jun

doi:10.1007/s00508-020-01668-z

Cited by 10 publications

(7 citation statements)

References 17 publications

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“…In this study, for the first time, we showed that serum HBP could be a useful biomarker to distinguish sepsis from AOSD and to determine disease activity in patients with AOSD. Several biomarkers have been proposed to distinguish the two diseases in early phase (8)(9)(10)(11)(12), and in particular, studies have showed that serum IL-18 could be used as a biomarker for differential diagnosis and AOSD disease evaluation (35). Serum IL-18 levels have been shown to be significantly higher in patients with AOSD than in other inflammatory diseases, and its concentration correlates with disease activity.…”

Section: Discussionmentioning

confidence: 99%

“…Grouping AOSD disease activity status by our method was somewhat arbitrary and divergent, so it may cause the results to be biased with other research units. Last, previous studies had proposed that PCT, IL-18 combined with fibroblast growth factor 2 (FGF 2) and modified Pouchot Score including elevated serum ferritin levels ( 12 , 33 , 36 ) could be a useful diagnostic tool to distinguish AOSD and sepsis. However, as our study was a retrospective design, many laboratory values such as ferritin, PCT, serum cytokine levels such as IL-18, IL-6 and interferon were not performed in all patients at that time.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have made progress in distinguishing the two diseases clinically in their early phases, but few potential biomarkers for AOSD with sufficiently high sensitivity and specificity have been identified. Previous studies indicate that levels of C-reactive protein, procalcitonin, lactate, some cytokines such as interleukin 18 (IL-18) and white blood cells (8)(9)(10)(11)(12) could help to distinguish between AOSD and sepsis. However, there were some reviews or meta-analysis indicated that these potential indicators have limited specificity in clinical practice (8,13,14).…”

Section: Introductionmentioning

confidence: 99%

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Serum Heparin-Binding Protein as a Potential Biomarker to Distinguish Adult-Onset Still’s Disease From Sepsis

et al. 2021

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Adult-onset Still’s disease (AOSD) is a systemic, multifactorial, autoinflammatory disease for which the etiopathogenesis is not well understood. Given the similarities in clinical and laboratory features between this disease and sepsis, and the differences in treatment strategies for these two diseases, specific diagnostic markers are crucial for the correct diagnosis and management of AOSD. Previous studies have shown plasma heparin-binding protein (HBP) is a promising potential biomarker for AOSD; thus, this study aimed to detect serum HBP levels in patients with AOSD or sepsis to assess its potential as a biomarker for differential diagnosis. We found that serum HBP levels were significantly higher in patients with active AOSD than that in those with inactive AOSD. Patients with sepsis had higher serum HBP levels compared with those who had active or inactive AOSD. We calculated the area under the receiver operating characteristic (ROC) curve to assess whether HBP could be used to differentiate active from inactive AOSD; this was 0.811 with sensitivity 0.650, specificity 0.811, and cutoff HBP value of 35.59 ng/ml. The area under the ROC curve for HBP as a biomarker to differentiate AOSD from sepsis was 0.653, with sensitivity 0.759, and specificity 0.552, and cutoff HBP value of 65.1 ng/ml. Taken together, the results of our study suggest that serum HBP could be a useful diagnostic biomarker to evaluate disease activity in patients with AOSD, and to differentiate AOSD from sepsis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum Heparin-Binding Protein as a Potential Biomarker to Distinguish Adult-Onset Still’s Disease From Sepsis

et al. 2021

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“…Platelets have been shown to be involved in the pathogenesis of pathological fibrosis. [28][29][30] In studies of some fibrotic diseases, such as scleroderma and liver fibrosis, platelets could promote fibroblast proliferation and the production of collagen by secreting profibrotic factors such as transforming growth factor beta and platelet-derived growth factor. The obvious proliferation of vascular fibroblasts is the most important pathological feature in TAK.…”

Section: F I G U R Ementioning

confidence: 99%

The role of plateletcrit in Takayasu arteritis: A potential biomarker for disease activity and 6‐month treatment response

Sun,

Cui,

Kong

et al. 2023

Int J of Rheum Dis

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ObjectivesTo determine the role of plateletcrit as a potential biomarker for disease activity and treatment response in Takayasu arteritis (TAK).MethodsTotally, 215 newly diagnosed TAK patients were consecutively enrolled. Demographic data, clinical manifestations, laboratory and imaging examinations, and treatment strategy were recorded at baseline and at each visit during the 6‐month treatment period. Normal plateletcrit (0.1%–0.4%) and hyper‐plateletcrit (>0.4%) observed at baseline were used as group criteria.ResultsAt baseline, the overall plateletcrit was 0.32 (0.24–0.38)%, with a normal and high level observed in 172 (80.00%) and 43 (20.00%) patients, respectively. Baseline plateletcrit was significantly higher in patients with active disease and associated with inflammatory biomarkers, including erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP), and interleukin (IL)‐6 (all p < .01). At 6 months, complete remission was achieved in 171 (79.53%) patients, and a significant decrease in plateletcrit was observed in these cases (p < .01). Patients with a normal baseline plateletcrit were more likely to achieve complete remission compared to those with a high baseline plateletcrit (HR = 4.65, 95% CI: 2.38–19.08, p < .01). In addition, ESR (p = .01) and IL‐6 (p = .02) levels were still higher in patients with a high baseline plateletcrit at 6 months. Progression of vascular lesions was indicated in 18 (8.37%) patients at 6 months, and these patients also had significantly higher baseline plateletcrit (p = .03).ConclusionPlateletcrit levels were positively related to disease activity and inflammatory index in TAK. Importantly, patients with high baseline plateletcrit levels may show a worse treatment response at 6 months.

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“…Because of the lack of speci c symptoms and indicators, the diagnosis of AOSD remains a challenge. In clinical practice, patients with AOSD presenting with systemic in ammatory response syndrome as the rst symptom are often di cult to distinguish from infectious diseases, especially septicemia (3,4).In recent years, many scientists have focused on the differential diagnosis of AOSD and sepsis, hoping to nd satisfactory biomarkers to distinguish them. Some common hematological markers have been reported, such as: Neutrophil index, platelet/platelet…”

mentioning

confidence: 99%

Establishment of a differential diagnosis method and an online prediction platform for AOSD and sepsis based on machine learning

Zhou

Xie

Wang

et al. 2023

Preprint

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Objective. The differential diagnosis between Adult-onset Still's disease (AOSD) and sepsis has always been a challenge. In this study, a machine learning model for differential diagnosis of AOSD and sepsis was developed and an online platform was developed to facilitate the clinical application of the model. Methods. All data were collected from 42 AOSD patients and 50 sepsis patients admitted to Affiliated Hospital of Xuzhou Medical University from December 2018 to December 2021. In addition, 5 AOSD patients and 10 sepsis patients diagnosed in our hospital after March 2022 were collected for external validation. All models were built using the scikit-learn library (version 1·0·2) in Python(version 3·9·7), and feature selection was performed using the SHAP (Shapley Additive exPlanation) package developed in Python. Results. The results showed that the gradient boosting decision tree(GBDT) optimization model based on arthralgia, ferritin × lymphocyte count, white blood cell count, ferritin × platelet count, and α1-acid glycoprotein/creatine kinase could well identify AOSD and sepsis. The training set interaction test (AUC: 0·9916, ACC: 0·9457, Sens: 0·9556, Spec: 0·9578) and the external validation also achieved satisfactory results (AUC: 0·9800, ACC: 0·9333, Sens: 0·8000, Spec: 1·000). We named this discrimination method AIADSS (AI-assisted discrimination of Still's disease and Sepsis) and created an online service platform for practical operation, the website is http://cppdd.cn/STILL1/. Conclusion. We created a method for the identification of AOSD and sepsis based on machine learning. This method can provide a reference for clinicians to formulate the next diagnosis and treatment plan.

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Combination value of biomarkers in discriminating adult onset Still’s disease and sepsis

Cited by 10 publications

References 17 publications

Serum Heparin-Binding Protein as a Potential Biomarker to Distinguish Adult-Onset Still’s Disease From Sepsis

Serum Heparin-Binding Protein as a Potential Biomarker to Distinguish Adult-Onset Still’s Disease From Sepsis

The role of plateletcrit in Takayasu arteritis: A potential biomarker for disease activity and 6‐month treatment response

Establishment of a differential diagnosis method and an online prediction platform for AOSD and sepsis based on machine learning

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