ISSN 2997-1036
International Journal of Hematology | Vol. 12, No. 1, January 2021 | pp. 1–8
DOI: 10.46882/2021/IJH/000131
Original Article
Title: Clinical relevance of serum soluble CD163 and ferritin kinetics as early markers of macrophage activation syndrome in adult-onset Still's disease
Names of Authors: A. I. Ibrahim¹, C. D. Balogun², E. O. Ojo³
Authors’ Affiliations: ¹Department of Haematology, Ahmadu Bello University, Zaria, Nigeria; ²Department of Medicine and Rheumatology, University of Ilorin, Ilorin, Nigeria; ³Department of Chemical Pathology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
Abstract: Macrophage activation syndrome is a severe hyperinflammatory condition characterized by cytopenias, multi-organ dysfunction, and extreme hyperferritinemia. This prospective cohort study evaluated the diagnostic accuracy of monitoring serum soluble CD163 (sCD163) relative to hyperferritinemia kinetics in 36 adult patients with active adult-onset Still's disease suspected of developing macrophage activation syndrome. Serum soluble CD163 levels were quantified using an enzyme-linked immunosorbent assay. Mean serum ferritin concentrations were significantly elevated in patients with confirmed macrophage activation syndrome (16,450 ± 3,400 ng/ml). Soluble CD163 concentrations were also markedly elevated, with a mean value of 16.4 ± 3.8 μg/ml compared to 1.8 ± 0.5 μg/ml in active disease controls without macrophage activation (P < 0.001). Soluble CD163 levels correlated strongly with falling platelet counts and elevated serum triglycerides (r = 0.62, P < 0.01). Receiver operating characteristic curve analysis established that a soluble CD163 threshold above 7.2 μg/ml yielded a diagnostic sensitivity of 91.6% and a specificity of 88.8%. Measuring soluble CD163 serves as a highly specific biomarker for active macrophage activation, helping differentiate this hyperinflammatory storm from typical underlying disease flare-ups.
Keywords: Macrophage activation syndrome, ferritin, soluble CD163, hemophagocytosis, adult-onset Still's disease
Manuscript Timeline: Received: October 12, 2020; Revised: November 18, 2020; Accepted: December 05, 2020; Published: January 14, 2021