ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 192

Clinical and Laboratory Findings in A Cohort of Italian Patients with Adult Onset Still’S Disease: The Role of IL-18 As A Disease Biomarker

Roberta Priori1, Serena Colafrancesco2, Carlo Perricone2, Antonina Minniti2, Cristiano Alessandri2, Giancarlo Iaiani3 and Guido Valesini2, 1Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy, 2Rheumatology Unit, Sapienza University of Rome, Rome, Italy, 3Department of Infectious Diseases and Tropical Medicine, Sapienza University of Rome, Rome, Italy

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: diagnosis, infection and interleukins (IL), Still's disease

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Title: Miscellaneous Rheumatic and Inflammatory Diseases: Periodic Fever Syndromes

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Adult Onset Still’s Disease (AOSD) is a systemic inflammatory syndrome driven by interleukin (IL)-18. Since differential diagnosis between AOSD, sepsis and other inflammatory conditions can be difficult, we aimed to investigate IL-18 serum levels in AOSD and to assess whether this cytokine could be used as disease biomarker. 

Methods:

Patients with AOSD (Yamaguchy criteria) were evaluated. Disease activity was assessed with Pouchot’s and Rau’s criteria and patients were defined active if they had ≥4 criteria. Serum IL-18 levels were detected by ELISA (Immuno-Pharmacology Research, Italy) in patients with AOSD and sepsis (according to ACCP/SCCM Consensus Conference). Furthermore, patients with Rheumatoid Arthritis (RA), Sjögren Syndrome (SS), Systemic Lupus Erythematosus (SLE) and healthy subjects (NHS) served as controls. Area under the receiver operating curve (ROC-AUC) analysis was used to evaluate the diagnostic utility of the IL-18. 

Results:

Clinical and laboratory features of 50 AOSD patients are described in table.

AOSD patients

N=50

Male/Female

23/27

Age at onset [mean (range), years]

34 (17-64)

Symptoms

N

%

Fever

50

100.0

Arthralgia

39

78.0

Rash

38

76.0

Sore Throat

30

60.0

Lymphadenopathy

29

58.0

Arthritis

24

48.0

Hepatomegaly

19

38.0

Splenomegaly

19

38.0

Myalgia

15

30.0

Pleuritis

3

6.0

Pericarditis

2

4.0

Abdominal Pain

1

2.0

Laboratory features

mean

range

ESR (mm/h)

74.8

20 – 124

CRP (mg/dl)

84.8

3 – 354

WBC (cells/µl)

19004.7

8600 – 35900

Ferritin (ng/ml)

5582

69 – 32800

AST (UI/l)

67.4

8 – 404

ALT (UI/l)

91.6

4 – 535

Two patients experienced DIC, one with fatal outcome. Considering Pouchot’s and Rau’s criteria, active patients were 18/50 (36%) and 21/50 (42%), respectively. Mean ferritin was higher in active than non active patients (p=0.001). IL-18 was detected in 30 patients with AOSD, 7 with sepsis, 21 with RA, 21 with SS, 20 with SLE and 21 NHS. IL-18 significantly correlates with AOSD activity score (p<0.0001) and ferritin level (p=0.0127). Mean IL-18 was significantly higher in AOSD than in sepsis [1298.7 pg/ml (range 0–6015) vs 113.5 pg/ml (range 52–328), p=0.008]. The ROC-AUC analysis for IL-18 serum levels between AOSD and sepsis was 0.712 [cut-off=179 pg/ml, specificity (sp)=69.7%, sensitivity (se)=87.5%, likelihood (LR)=2.89]. IL-18 serum levels were significantly higher in active than non active patients and sepsis (p=0.0039 and p=0.007, respectively). The ROC-AUC analysis for IL-18 between active AOSD and sepsis was 0.845 (cut-off=223 pg/ml, sp=87.5%, se=80.9%, LR=6.48). The ROC-AUC analyses for IL-18 between AOSD patients and other groups (NHS, RA, SS, SLE) were respectively 0.853 / 0.720 / 0.750 / 0.791 (NHS: cut-off=293.7 pg/ml, sp=85.19%, se=85.71%, LR=5.79; RA: cut-off=335.5 pg/ml, sp=81.48%, se=52.38%, LR=2.83; SS: cut-off=424.3 pg/ml, sp=74.07%, se=66.67%, LR=2.57; SLE: cut-off =268.2 pg/ml, sp=85.19%, se=60%, LR=4.05). 

Conclusion:

The clinical and laboratory findings of our cohort overlap with the literature. Ferritin parallels disease activity, suggesting that the Rau’s criteria could be more accurate. AOSD prognosis is usually favourable but severe complications may occur. Finally, a significant difference in IL-18 serum levels between patients with AOSD and sepsis was observed, and IL-18 can represent a useful biomarker in the differential diagnosis between AOSD and other inflammatory conditions. Moreover, IL-18 serum levels reflects disease activity.


Disclosure:

R. Priori,
None;

S. Colafrancesco,
None;

C. Perricone,
None;

A. Minniti,
None;

C. Alessandri,
None;

G. Iaiani,
None;

G. Valesini,
None.

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/clinical-and-laboratory-findings-in-a-cohort-of-italian-patients-with-adult-onset-stills-disease-the-role-of-il-18-as-a-disease-biomarker/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology