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Elevated monocyte distribution width in patients with active adult-onset Still’s disease: a novel activity indicator
Y.-H. Lin1, S.-H. Chang2, T.-C. Hsu3, P.-K. Chen4, J.-L. Lan5, D.-Y. Chen6
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan.
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung; College of Medicine, China Medical University, Taichung; and PhD Program in Translational Medicine and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan.
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan.
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung; College of Medicine, China Medical University, Taichung; and Translational Medicine Laboratory, Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan.
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung; College of Medicine, China Medical University, Taichung; and Rheumatic Diseases Research Center, China Medical University Hospital, Taichung, Taiwan.
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung; College of Medicine, China Medical University, Taichung; PhD Program in Translational Medicine and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung; Translational Medicine Laboratory, Rheumatology and Immunology Center, China Medical University Hospital, Taichung; and Institute of Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan. dychen1957@gmail.com
CER16596
2023 Vol.41, N°10
PI 2062, PF 2070
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PMID: 37470238 [PubMed]
Received: 15/02/2023
Accepted : 12/06/2023
In Press: 13/07/2023
Published: 30/10/2023
Abstract
OBJECTIVES:
Monocyte distribution width (MDW) correlates with volume modifications of circulating monocytes upon activation. Given the crucial role of monocyte activation in the pathogenesis of adult-onset Still’s disease (AOSD), we aimed to examine the associations between MDW and disease activity or inflammatory parameters in this disease.
METHODS:
In 58 AOSD patients and 95 other patients with coronavirus disease 2019 (COVID-19) as disease control, MDW and complete blood count were determined using a UniCel DxH800 analyser. C-reactive protein (CRP) levels were measured by nephelometry, and ferritin levels by chemiluminescent immunoassay. AOSD activity was assessed using a modified Pouchot score.
RESULTS:
MDW was significantly higher in active AOSD patients (median 28.3, interquartile range [IQR] 23.3-32.1) compared with inactive AOSD (19.2, IQR 18.0-20.6, p<0.001) or non-severe COVID-19 patients (23.2, IQR 21.0-25.2, p<0.01). MDW was positively correlated with AOSD activity scores, CRP, and ferritin levels (all p<0.001). Longitudinal follow-up evaluation revealed that median MDW significantly declined (28.3 versus 18.5, p<0.001) along with disease activity, paralleling a decrease in CRP and ferritin levels. Severe COVID-19 and sepsis patients had elevated MDW, which were not different from active AOSD patients. Multivariate analysis revealed MDW as a significant predictor of active AOSD, and MDW threshold at 21.7 could predict an active status with a high sensitivity of 91.3% and specificity of 94.3%.
CONCLUSIONS:
Elevated MDW and its positive correlation with inflammatory parameters in AOSD patients indicate MDW as a novel activity indicator, with a high MDW value above 21.7 linked to a high probability of active AOSD.
