Combination value of biomarkers in discriminating adult onset Still's disease and sepsis.

BACKGROUND: Lymphocyte and plateletcrit (PCT) as proportions of routine complete blood count tests, have been studied as simple biomarkers for inflammatory diseases. The aim of our study was to investigate whether blood routine parameters, especially platelet parameters could be a useful tool to distinguish Adult onset Still's disease (AOSD) from sepsis. METHODS: We retrospectively reviewed 58 patients with AOSD and 55 sepsis patients diagnosed at the First Affiliated Hospital of Nanjing Medical University between January, 2015 to December 2018. Laboratory data including ferritin, blood routine parameters and C­reactive protein (CRP) level were collected, and the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR) were calculated. RESULTS: The results showed that AOSD patients showed higher ferritin, lymphocyte and PCT (all P < 0.01) and these factors are independent risk factors for predicting AOSD. In receiver operating characteristic (ROC) curve analysis of LY, PCT and ferritin for distinguish of AOSD, the area under the curve (AUC) was 0.676 (0.576-0.777); 0.706 (95% CI = 0.596-0.816); 0.715 (0.617-0.814). Meanwhile, the AUC of the combination of lymphocyte, PCT and ferritin was 0.836 (0.737-0.909) with sensitivity 67.3, specificity 92.3, and the difference was significant. CONCLUSIONS: Thus we suggest that lymphocyte, PCT may be a useful tool to make a distinction between AOSD and sepsis, as supplementary biomarkers to ferritin.