Serum HO-1 is useful to make differential diagnosis of secondary hemophagocytic syndrome from other similar hematological conditions

被引:18
作者
Miyazaki, Takuya [1 ]
Kirino, Yohei [1 ]
Takeno, Mitsuhiro [1 ]
Hama, Maasa [1 ]
Ushihama, Ayumi [1 ]
Watanabe, Reina [1 ]
Takase, Kaoru [2 ]
Tachibana, Takayoshi [1 ]
Matsumoto, Kenji [1 ]
Tanaka, Masatsugu [1 ]
Yamaji, Satoshi [1 ]
Ideguchi, Haruko [2 ]
Tomita, Naoto [1 ]
Fujita, Hiroyuki [1 ]
Ohno, Shigeru [2 ]
Ueda, Atsuhisa [1 ]
Ishigatsubo, Yoshiaki [1 ]
机构
[1] Yokohama City Univ, Grad Sch Med, Dept Internal Med & Clin Immunol, Kanazawa Ku, Kanagawa 2360004, Japan
[2] Yokohama City Univ, Med Ctr, Ctr Rheumat Dis, Kanagawa 2360004, Japan
关键词
Heme oxygenase; Hemophagocytic syndrome; Ferritin; Macrophage; ONSET STILLS-DISEASE; HEME OXYGENASE-1; IRON OVERLOAD; GUIDELINES; LYMPHOHISTIOCYTOSIS; HEME-OXYGENASE-1; MACROPHAGES; DEFICIENCY; MONOCYTES; LIVER;
D O I
10.1007/s12185-010-0495-y
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Heme oxygenase (HO)-1, a heme-degrading enzyme inducible by various stimuli, plays a key role in the regulation of inflammatory response in monocytes/macrophages. The serum HO-1 level is remarkably increased in patients with secondary hemophagocytic syndrome (HPS) or adult-onset Still's disease. We measured serum HO-1 levels in patients with a variety of hematological diseases, including secondary HPS, by means of ELISA. Serum HO-1 levels were significantly higher in 22 patients with HPS (134.7 +/- 116.2 ng/mL, P < 0.0001) at diagnosis than in 80 patients with other hematological diseases. The most effective cutoff point between HPS and other conditions was 14.5 ng/mL, with 100.0% sensitivity and 96.3% specificity. In HPS patients, the serum HO-1 levels showed the highest correlation with serum ferritin (r = 0.682, P = 0.0005), which reflects the disease activity of HPS. Moreover, both HO-1 and ferritin levels were reduced in parallel after successful treatment in patients with HPS, irrespective of underlying diseases. However, HO-1 levels were not elevated in patients with other causes of hyperferritinemia. These data demonstrate that serum HO-1 can distinguish secondary HPS from other hematological diseases, including those associated with hyperferritinemia.
引用
收藏
页码:229 / 237
页数:9
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