PMID- 30886992
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220408
IS  - 2520-1026 (Electronic)
IS  - 2520-1026 (Linking)
VI  - 3
DP  - 2019
TI  - Comparative study of Interleukin-18 (IL-18) serum levels in adult onset Still's 
      disease (AOSD) and systemic onset juvenile idiopathic arthritis (sJIA) and its 
      use as a biomarker for diagnosis and evaluation of disease activity.
PG  - 4
LID - 10.1186/s41927-019-0053-z [doi]
LID - 4
AB  - BACKGROUND: Signs and symptoms establish the diagnosis of adult onset Still's 
      disease (AOSD) as well as of systemic onset juvenile idiopathic arthritis (sJIA). 
      The published data regarding the importance of IL-18 as a marker for diagnosis 
      and disease activity so far are conflicting. The aim of this study was to clarify 
      the role of IL-18 as a diagnostic and disease activity marker in AOSD and sJIA. 
      METHODS: Thirty adult patients diagnosed with AOSD and twenty children diagnosed 
      with sJIA were included in the study. Clinical and laboratory data were obtained 
      retrospectively for each patient visit whenever IL-18 serum levels were 
      determined. IL-18 levels were determined by ELISA. Sixty-five adults and 
      twenty-three children presenting with fever and/or arthritis who did not meet the 
      criteria for a diagnosis of AOSD or sJIA served as comparison groups. Rau's 
      criteria and CRP values were used to evaluate disease activity. RESULTS: IL-18 
      levels were significantly elevated in patients with active AOSD compared to AOSD 
      patients in remission and to the comparison group with a median of 16,327 pg/ml, 
      470 pg/ml, and 368 pg/ml, respectively (p < 0.001). Analogous to AOSD in active 
      sJIA, the median IL-18 serum level was significantly higher with 21,512 pg/ml 
      than in the comparison group with 2580 pg/ml (p < 0.001).At our cut-off point of 
      5000 pg/ml, the calculated specificity of IL-18 to establish the diagnosis of 
      AOSD was 96.9%, and the sensitivity 63.3% (AUC = 0.870, p < 0.001). For the 
      diagnosis of sJIA, a cut-off value of 10,000 pg/ml was chosen with a specificity 
      of 100% and a sensitivity of 60% (AUC = 0.774, p = 0.003). At a cut-off value of 
      5000 pg/ml, the specificity was 62% and the sensitivity 65%. CONCLUSIONS: This 
      study gives further evidence to earlier publications of elevated IL-18 serum 
      levels in active AOSD and sJIA, with up to 1000-fold higher concentrations 
      compared to other rheumatic diseases. A clear association of IL-18 serum levels 
      with disease activity in AOSD was found. The results support the use of IL-18 as 
      an important biomarker in AOSD and sJIA.
FAU - Kudela, Holger
AU  - Kudela H
AUID- ORCID: 0000-0002-2207-1323
AD  - 1Clinic of Rheumatology, University of Magdeburg, Sophie-von-Boetticher-Strasse 
      1, 39245 Vogelsang-Gommern, Germany. ISNI: 0000 0001 1018 4307. GRID: grid.5807.a
FAU - Drynda, Susanne
AU  - Drynda S
AD  - 1Clinic of Rheumatology, University of Magdeburg, Sophie-von-Boetticher-Strasse 
      1, 39245 Vogelsang-Gommern, Germany. ISNI: 0000 0001 1018 4307. GRID: grid.5807.a
FAU - Lux, Anke
AU  - Lux A
AD  - 2Institute for Biometry and Medical Informatics, University of Magdeburg, 
      Leipziger Strasse 44, 39120 Magdeburg, Germany. ISNI: 0000 0001 1018 4307. GRID: 
      grid.5807.a
FAU - Horneff, Gerd
AU  - Horneff G
AD  - Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Arnold-Janssen 
      Strasse 29, 53757 Sankt Augustin, Germany.
AD  - 4Department of Pediatric and Adolescents medicine, Medical Faculty, University 
      Hospital of Cologne, Cologne, Germany. ISNI: 0000 0000 8852 305X. GRID: 
      grid.411097.a
FAU - Kekow, Joern
AU  - Kekow J
AD  - 1Clinic of Rheumatology, University of Magdeburg, Sophie-von-Boetticher-Strasse 
      1, 39245 Vogelsang-Gommern, Germany. ISNI: 0000 0001 1018 4307. GRID: grid.5807.a
LA  - eng
PT  - Journal Article
DEP - 20190228
PL  - England
TA  - BMC Rheumatol
JT  - BMC rheumatology
JID - 101738571
PMC - PMC6394042
OTO - NOTNLM
OT  - Adult onset Still's disease (AOSD)
OT  - Disease activity
OT  - Interleukin-18 (IL-18)
OT  - Systemic onset juvenile arthritis (sJIA)
COIS- The study has been performed in accordance with the Declaration of Helsinki and 
      was approved by the ethics committee (Ethik-Kommission der Medizinischen Fakultat 
      der Otto-von-Guericke-Universitat, Leipziger Strasse 44, 39,120 Magdeburg) of the 
      Medical Faculty of the Otto-von-Guericke-University Magdeburg under the reference 
      number 71/99. All participants provided written informed consent. For the 
      participating children written informed consent was obtained from their 
      parents/legal guardians.Not applicable.The authors declare that there is no 
      conflict of interest regarding the publication of this article. The study centers 
      did not receive any financial support nor was there a conflict of interest 
      regarding data analysis or manuscript writing. The clinical part of the study, 
      the statistics and manuscript preparation were performed within the scope of the 
      duties of the hospitals involved without additional funding. The authors did not 
      receive any funding, grants, honoraria or any other form of recognition or 
      compensation of any kind from a sponsor.Springer Nature remains neutral with 
      regard to jurisdictional claims in published maps and institutional affiliations.
EDAT- 2019/03/20 06:00
MHDA- 2019/03/20 06:01
PMCR- 2019/02/28
CRDT- 2019/03/20 06:00
PHST- 2018/03/07 00:00 [received]
PHST- 2019/01/25 00:00 [accepted]
PHST- 2019/03/20 06:00 [entrez]
PHST- 2019/03/20 06:00 [pubmed]
PHST- 2019/03/20 06:01 [medline]
PHST- 2019/02/28 00:00 [pmc-release]
AID - 53 [pii]
AID - 10.1186/s41927-019-0053-z [doi]
PST - epublish
SO  - BMC Rheumatol. 2019 Feb 28;3:4. doi: 10.1186/s41927-019-0053-z. eCollection 2019.