ArticlePloS one2020
Ferritin and C-reactive protein are predictive biomarkers of mortality and macrophage activation syndrome in adult onset Still's disease. Analysis of the multicentre Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Systemic juvenile idiopathic arthritis and adult-onset Still's disease are the same disease: evidence from systematic reviews and meta-analyses informing the 2023 EULAR/PReS recommendations for the diagnosis and management of Still's disease.Annals of the rheumatic diseases · 2024Pooled it
- Early C-reactive protein and ferritin kinetics after tocilizumab initiation predict macrophage activation syndrome in Still disease: a single-centre retrospective cohort study.EULAR rheumatology open · 2026Article
- A Multifaceted Interplay Among Hemophagocytosis, Interleukin-18, and Type I Interferon Distinguishes Still Disease From Other Autoinflammatory Diseases.Arthritis & rheumatology (Hoboken, N.J.) · 2026Article
- Article
- Relationship of Ferritin and Procalcitonin with SOFA-2 Scores in Intensive Care Patients with COVID-19-Associated Sepsis: A Cross-Sectional Analysis.Biomedicines · 2026Article
- Development of a predictive tool for hemophagocytic lymphohistiocytosis/macrophage activation syndrome risk in adult-onset Still's disease.Frontiers in immunology · 2026Article
- Etiologic spectrum and early mortality predictors in extreme hyperferritinemia: insights from rheumatology and hematology clinics.Clinical rheumatology · 2026Article
- Application of machine learning techniques to explore the occurrence of macrophage activation syndrome in Still's disease: results from the GIRRCS AOSD Study Group and the AIDA Network Still's Disease Registry.Frontiers in immunology · 2026Observational
- Real-world therapeutic strategies in active adult-onset Still's disease: clinical insights from the GIRRCS-AOSD study group.Frontiers in immunology · 2026Article
- Assessment of Health-Related Quality of Life in Patients with Active Versus Inactive Adult-Onset Still's Disease: Data from the PRO-AOSD Survey During the COVID-19 Pandemic.Journal of clinical medicine · 2025Article
- Clinical characteristics and prognostic factors in adult macrophage activation syndrome: an observational study in a Chinese cohort.Lupus science & medicine · 2025Observational
- Evaluating the Divide Between Patients' and Physicians' Perceptions of Adult-Onset Still's Disease Cases: Insights from the PRO-AOSD Survey.Journal of clinical medicine · 2025Article
- nCD64 index as a new early predictive biomarker for macrophage activation syndrome in adult-onset still's disease.Arthritis research & therapy · 2025Article
- Recent advances and evolving concepts in Still's disease.Nature reviews. Rheumatology · 2024Review
- [Clinical characteristics and diagnostic indicators of macrophage activation syndrome in patients with systemic lupus erythematosus and adult-onset Still's disease].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2023Article
- Observational
- C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians.Diseases (Basel, Switzerland) · 2023Review
- Ferritin and myalgic encephalomyelitis/chronic fatigue syndrome in post COVID-19, an unexpected facet of the hyperferritinemic syndrome?Journal of psychosomatic research · 2023Article
- Diagnosis and treatment of adult-onset Still's disease: a concise summary of the German society of rheumatology S2 guideline.Zeitschrift fur Rheumatologie · 2023Review
- The specialized pro-resolving lipid mediator Protectin D1 affects macrophages differentiation and activity in Adult-onset Still's disease and COVID-19, two hyperinflammatory diseases sharing similar transcriptomic profiles.Frontiers in immunology · 2023Article
Corrections and comments
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Authors and funding
15 authors at 9 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the predictive role of ferritin and C-reactive protein (CRP) on occurrence of macrophage activation syndrome (MAS) and mortality in patients with adult onset Still's disease (AOSD), a rare and severe disease, included in the multicentre Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort.
methodsThe predictive role, at the time of diagnosis, of serum levels of ferritin and CRP on occurrence of MAS and mortality, was evaluated by logistic regression analyses and receiver-operating characteristic (ROC) curves were built to identify patients at high risk of MAS and mortality, respectively.
resultsIn assessed 147 patients with AOSD, levels of ferritin were predictive of MAS (OR: 1.971; P: 0.002; CI 95%: 1.280-3.035). The ROC curve showed that the best cut-off for ferritin was 1225 ng/ml in predicting MAS (sensitivity 88%; specificity 57%). Levels of CRP were predictive of mortality in these patients (OR: 2.155; P: 0.007; CI 95%: 1.228-3.783). The ROC curve showed that the best cut-off for CRP was 68.7 mg/L in predicting mortality (sensitivity 80%; specificity of 65%).
conclusionsWe reported the predictive role of ferritin and CRP on MAS and mortality, respectively, in a large cohort of patients with AOSD, identifying subsets at higher risk of poor prognosis. Considering that the analysis of CRP and ferritin is widely available, these results could be readily transferable into clinical practice, thus improving the management of patients with AOSD.
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