ISSN 2997-1036
International Journal of Hematology | Vol. 4, No. 5, May 2013 | pp. 33–40
DOI: 10.46882/2013/IJH/000041
Original Article
Title: Clinical relevance of soluble CD163 and serum ferritin levels as biomarkers in macrophage activation syndrome
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, life-threatening complication of systemic inflammatory diseases characterized by cytopenias, hyperferritinemia, and multi-organ dysfunction. This prospective study evaluated the diagnostic performance of soluble CD163 relative to hyperferritinemia in 32 patients suspected of having macrophage activation syndrome secondary to systemic autoimmune disorders. Serum soluble CD163 levels were quantified using an enzyme-linked immunosorbent assay, and bone marrow aspirates were evaluated for hemophagocytosis. Mean serum ferritin concentrations were significantly elevated in patients with confirmed macrophage activation syndrome (14,250 ± 3,400 ng/ml). Soluble CD163 levels were also markedly elevated, with a mean value of 18.6 ± 4.2 μg/ml compared to 1.8 ± 0.5 μg/ml in active autoimmune controls without macrophage activation syndrome (P < 0.001). Soluble CD163 concentrations correlated strongly with the severity of cytopenias and elevated triglycerides (r = 0.64, P < 0.01). Receiver operating characteristic curve analysis demonstrated that a soluble CD163 threshold above 7.5 μg/ml yielded a diagnostic sensitivity of 92.5% and a specificity of 88.6%. Measuring soluble CD163 serves as a highly specific biomarker for active macrophage activation, helping differentiate this hyperinflammatory syndrome from flare-ups of underlying autoimmune conditions.
Keywords: Macrophage activation syndrome, ferritin, soluble CD163, hemophagocytosis, autoimmune disease
Manuscript Timeline: Received: February 10, 2013; Revised: March 18, 2013; Accepted: April 05, 2013; Published: May 14, 2013