OP0084 Serum fibroblast growth factor 2 is a useful biomarker to distinguish adult onset still disease from sepsis

Background The precise cytokine networks in the serum of individuals with adult onset still disease (AOSD) that are associated with its pathogenesis have been unknown. Serum levels of interleukin (IL)−1β, IL-6 and IL-18 have been reported as useful serum biomarkers for diagnosis and disease evaluation among AOSD patients,1 2 but these cytokines are also elevated in other inflammatory diseases including severe infection. Objectives We attempted to identify specific biomarkers to distinguish AOSD from sepsis. Methods We measured serum levels of 45 cytokines in 66 AOSD patients, 17 sepsis patients and 133 age-matched controls by multi-suspension cytokine array. Japan College of Rheumatology-certified rheumatologists diagnosed with AOSD based on the Yamaguchi criteria. Cytokines were ranked by their importance by a multivariate classification algorithm. We performed a logistic regression analysis to determine specific biomarkers for discriminating AOSD from sepsis patients. To identify specific molecular networks, we performed a cluster analysis of each cytokine. Results Serum fibroblast growth factor 2 (FGF-2), vascular endothelial growth factor (VEGF), granulocyte-colony stimulating factor (G-CSF), and IL-18 levels were significantly elevated in the AOSD group versus the sepsis group. Multivariate classification algorithms followed by a logistic regression analysis revealed that the measurement FGF-2 distinguished AOSD patients from sepsis patients with the highest accuracy (cut-off value=28.5 pg/mL, sensitivity 100%, specificity 88.2%, accuracy 96.7%). Conclusions We have demonstrated that FGF-2 can be the best biomarker for differential diagnosis between AOSD and sepsis based on the measurement of multiple cytokines. Although the differential diagnosis between rheumatic diseases and infectious conditions is a great challenge in clinical practice, these findings help to improve the diagnostic performance of AOSD in daily practice. References [1] Clin Exp Rheumatol. 1996Nov–Dec;14(6):653–5. [2] Rheumatology (Oxford)2016Dec;55(12):2237–2247. Disclosure of Interest None declared