Percentage of glycosylated serum ferritin remains low throughout the course of adult onset Still's disease

Objective-To determine the evolution of levels of total serum ferritin and percentage of the glycosylated form in patients with adult onset Still's di sease (AOSD) at the time of diagnosis and during follow up. Methods-All pat ients with AOSD were tested at the time of diagnosis and during follow up. Total serum ferritin levels were analysed by immunoassay, and the percentag e of glycosylated ferritin was determined by methods using Sepharose-Con A. Results-14 patients (eight women, six men) with AOSD were enrolled. At the time of diagnosis, mean (SD) age was 36 (16) years. Mean initial total seru m ferritin was 6350 (1300) mu g/l (normal <250 mu g/l). The mean initial pe rcentage of glycosylated ferritin was 14.7 (13)% (normal >50%). Mean follow up time was 37 (35) months. At the time of the last examination all patien ts were in remission except one, who presented a chronic articular form. To tal serum ferritin remained high in this single patient and was normal in t he 13 others, with a mean of 98 (73) mu g/l. In all patients the percentage of glycosylated ferritin remained low, with a mean of 16 (16)%. Conclusion-Total serum ferritin is a marker of the active phase of AOSD. Th e percentage of glycosylated ferritin is low both in the active phase and i n remission. Further studies are needed to confirm these data and to determ ine their specificity for AOSD before considering any possible use of a low percentage of glycosylated ferritin as a diagnostic tool in suspected AOSD , especially when atypical or previously treated.