Platelet parameters aid identification of adult-onset Still's disease from sepsis.

BACKGROUND

Adult-onset Still's disease (AOSD) is a rare, chronic, and systemic inflammatory disorder. The current study aims to evaluate the ability of platelets (PLTs), plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), and PLT to PDW ratio (PPR) in a cohort of patients with AOSD or sepsis.

METHODS

Serum samples were obtained from 82 AOSD patients, 48 sepsis patients, and 76 matched healthy controls. Platelet parameters were measured by Sysmex XE 2100 analysers.

RESULTS

PPR and ferritin in AOSD patients were significantly higher than those in sepsis patients (22.18 ±; 11.12 vs. 13.80 ±; 8.97, p < 0.001; 3972.90 ±; 5134.04 μg/l vs. 518.92 ±; 382.50 μg/l, p = 0.001, respectively) and they were independent factors to differentiate AOSD from sepsis (OR: 5.86, 95%CI 1.59-21.60, p = 0.008; OR: 54.06, 95%CI 9.57-305.44, p < 0.001; respectively). Furthermore, PPR in AOSD and sepsis was significantly higher than that in matched controls. The area under the ROC curve of PPR, ferritin, and the combination were 0.733 (95%CI 0.646-0.820), 0.887 (95%CI 0.825-0.950), and 0.931 (95%CI 0.884-0.984), respectively.

CONCLUSION

PPR can be used as a useful marker to differentiate AOSD from sepsis and the combined identification value of PPR and ferritin is much higher than that of any single factor.