GLYCOSYLATED FERRITIN MEASURING SIGNIFICANCE FOR SECONDARY HEMOPHAGOCYTIC SYNDROME DIAGNOSTICS
Author(s): ,
Vsevolod Potapenko
Affiliations:
Municipal clinical hospital №31,Saint-Petersburg,Russian Federation
,
Margarita Pervakova
Affiliations:
Academician I.P. Pavlov First St. Petersburg State Medical University,Saint-Petersburg,Russian Federation
,
Sergey Lapin
Affiliations:
Academician I.P. Pavlov First St. Petersburg State Medical University,Saint-Petersburg,Russian Federation
,
Anna Klimovich
Affiliations:
Municipal clinical hospital №31,Saint-Petersburg,Russian Federation
,
Olga Mironova
Affiliations:
Municipal clinical hospital №31,Saint-Petersburg,Russian Federation
,
Nina Petrova
Affiliations:
Municipal clinical hospital №31,Saint-Petersburg,Russian Federation
,
Natalia Chernookaya
Affiliations:
Municipal clinical hospital №31,Saint-Petersburg,Russian Federation
,
Natalia Skorobogatova
Affiliations:
Municipal clinical hospital №31,Saint-Petersburg,Russian Federation
,
Elena Karyagina
Affiliations:
Municipal hospital №15,Saint-Petersburg,Russian Federation
,
Egor Karev
Affiliations:
I.I. Mechnikov North-Western State Medical University,Saint-Petersburg,Russian Federation
,
Elena Pavluchenko
Affiliations:
I.I. Mechnikov North-Western State Medical University,Saint-Petersburg,Russian Federation
,
Nadezhda Potikhonova
Affiliations:
Russian Scientific Research Institute of Hematology and Transfusiology,Saint-Petersburg,Russian Federation
,
Tatyana Kulibaba
Affiliations:
Saint-Petersburg State University,Saint-Petersburg,Russian Federation
,
Nadezhda Medvedeva
Affiliations:
Municipal clinical hospital №31,Saint-Petersburg,Russian Federation
Boris Afanasyev
Affiliations:
Academician I.P. Pavlov First St. Petersburg State Medical University,Saint-Petersburg,Russian Federation
EHA Library. Potapenko V. 05/18/17; 180930; E1154
Mr. Vsevolod Potapenko
Mr. Vsevolod Potapenko
Contributions
Abstract

Abstract: E1154

Type: Eposter Presentation

Background

Hemophagocytic syndrome (HPS) is a clinicopathologic condition characterized by systemic inflammatory reaction with cytopenia and tissue damage. The HPS may be primary (genetic associated) or secondary (SHPS), caused by different systemic disorders (immune, infectious, neoplastic). The overall clinical symptoms are similar to sepsis, so it could be difficult to differentiate among these entities. Ferritin levels are high in both cases, but the glycosylated/nonglycosylated ferritin fractions ratio is seems to be indicative.

Aims
The estimation of the ferritin fractions ratio and biochemical profile in patients with sepsis and SHPS.

Methods
The data from 64 patients were analyzed: 40 pts with diagnosed SHPS (median age 57, range 8-74 years) and 24 with lethal septic shock (median age 57.5, range 18-82 years). SHPS in patients with persistent fever refractory to antibacterial therapy and/or prolonged cytopenia and/or organ (lungs, CNS) involvement was established after the other conditions had been excluded. Sepsis diagnostics was based on the confirmed infection site and systemic inflammation with multiorgan failure. The following serum values were analyzed: alkaline phosphatase (AlPh), alanine aminotransferase (ALAT), asparagine aminotransferase (ASAT), lactate dehydrogenase (LDH), bilirubin, creatinine, INR, C-reactive protein (CRP), procalcitonin (PCT), total ferritin, and glycosylated ferritin percentage. Mann-Whitney U test and ROC-analysis were used for statistical analyses.

Results
No differences were found in sepsis and SHPS for ALAT, ASAT, AlPh, LDH, and bilirubin levels. The difference of INR, CRP, PCT, creatinine levels was significant (p<0.01). The most substantinal difference in SHPS and sepsis groups had serum concentrations of ferritin, triglycerides, level of ferritin glycosylation (p<0.01) (Table 1).

According to ROC-analysis, the area under the curve for ferritin, triglycerides and percentage of ferritin glycosylation were 0.78, 0.82, and 0.92, respectively.

Conclusion
The most difference between sepsis and SHPS was observed for triglycerides, ferritin and percentage of glycosylated ferritin. Percentage of glycosylated ferritin fraction seems to be the most indicative, which may make it useful for SHPS diagnostics and its differentiation from sepsis.

Session topic: 28. Iron metabolism, deficiency and overload

Keyword(s): Sepsis, Glycosylation, Ferritin

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