MRP8/14 serum levels as diagnostic markers for systemic juvenile idiopathic arthritis in children with prolonged fever.

Autor:	Park C; Department of Pediatric Rheumatology and Immunology, University Hospital Children's Muenster, Muenster., Miranda-Garcia M; Department of Pediatric Rheumatology and Immunology, University Hospital Children's Muenster, Muenster., Berendes R; St Marien Children's Hospital., Horneff G; Department of Paediatric Rheumatology, Kinderkrankenhaus Sankt Marien gGmbH, Landshut., Kuemmerle-Deschner J; Pediatric Rheumatology and Autoinflammatory Reference Center, University Children's Hospital Tuebingen, University of Tuebingen, Tuebingen., Ganser G; Division of Paediatric Rheumatology, Northwest German Rheumatology Center, St. Josef Stift, Sendenhorst., Huppertz HI; Prof.-Hess Children's Hospital and Gesundheit Nord Klinikverbund Bremen, Bremen., Minden K; Charité University Medicine and Epidemiology Unit, German Rheumatism Research Centre, Germany, Berlin., Haas JP; German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen., Jansson AF; Department of Rheumatology and Immunology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich., Borte M; Paediatric Rheumatology, Immunology and Infectiology, Hospital St Georg, Leipzig., Schuetz C; Department of Paediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden., Oommen P; Department of Pediatric Oncology, Hematology and Clinical Immunology, University Children's Hospital, Medical Faculty, Heinrich-Heine-University, Düsseldorf., Frosch M; German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln., Schlueter B; Center for Laboratory Medicine, University Hospital Muenster, Muenster., Richter-Unruh A; Department of Pediatric Endocrinology and Diabetes, University of Bochum, Bochum., Kessel C; Department of Pediatric Rheumatology and Immunology, University Hospital Children's Muenster, Muenster., Hinze C; Department of Pediatric Rheumatology and Immunology, University Hospital Children's Muenster, Muenster., Wittkowski H; Department of Pediatric Rheumatology and Immunology, University Hospital Children's Muenster, Muenster., Roth J; Institute of Immunology, University of Muenster, Muenster., Foell D; Department of Pediatric Rheumatology and Immunology, University Hospital Children's Muenster, Muenster., Holzinger D; Department of Pediatric Hematology-Oncology, University of Duisburg-Essen, Essen, Germany.
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2022 Jul 06; Vol. 61 (7), pp. 3082-3092.
DOI:	10.1093/rheumatology/keab729
Abstrakt:	Objectives: Differential diagnosis in children with prolonged fever is challenging. In particular, differentiating systemic-onset JIA (SJIA) from infectious diseases is difficult. Biomarkers are needed that support the diagnostic work-up. The aim of this study was to validate the usefulness of Myeloid-related protein 8/14 (MRP8/14) measurements in the diagnostic work-up of febrile children and to transfer it to clinical practice. Methods: Data for 1110 paediatric patients were included and divided into two cohorts: (cohort A) for validation of MRP8/14 test performance with three different testing systems: the experimental ELISA, commercial ELISA and an innovative (point-of-care test) lateral flow immunoassay (LFIA); (cohort B) to validate the diagnostic accuracy with the two latter assays. Results: In cohort A (n = 940), MRP8/14 was elevated in SJIA (12 110 ± 2650 ng/ml mean ± 95% CI) compared with other diagnoses (including infections and autoinflammatory diseases; 2980 ± 510 ng/ml) irrespective of fever and anti-inflammatory treatment (P < 0.001). In untreated patients with fever (n = 195) MRP8/14 levels in SJIA (19 740 ± 5080 ng/ml) were even higher compared with other diagnoses (4590 ± 1160 ng/ml) (P < 0.001, sensitivity 73%, specificity 90%). In group B1, the performance of the tests was confirmed in untreated patients with fever (n = 170): commercial ELISA (sensitivity 79%, specificity 89%) and LFIA (sensitivity 84%, specificity 81%). Compared with ferritin, IL-18, ESR, soluble IL-2 receptor and procalcitonin, MRP8/14 showed the best accuracy. Conclusion: MRP8/14 serum analyses have been validated as a helpful tool supporting the diagnosis of SJIA in febrile children. The results could be confirmed with commercial ELISA and LFIA enabling a rapid diagnostic point-of-care screening test. (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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