Article Text

PDF
THU0567 Comparative Performance of Fautrel and Yamaguchi Criteria for The Classification of Patients with Adult Onset Still Disease: Preliminary Results
  1. D. Lebrun1,
  2. S. Mestrallet2,
  3. M. Dehoux3,
  4. J.-L. Golmard4,
  5. S. Georgin-Lavialle5,
  6. L. Arnaud6,
  7. G. Grateau5,
  8. J. Pouchot7,
  9. B. Fautrel8
  1. 1Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, Reims
  2. 2Department of Internal Medicine and Infectious Diseases, Manchester Hospital, Charleville-Mézières
  3. 3Metabolic and Cellular Biochemistry Laboratory, Bichat-Claude Bernard Hospital
  4. 4Department of Biostatistics, Pitié-Salpêtrière Hospital
  5. 5APHP, Department of Internal Medicine, Reference Center for Amyloidosis and Familial Mediterranean Fever, Tenon Hospital
  6. 6UPMC, GRC 08, Pierre Louis Institute of Epidemiology and Public Health
  7. 7Department of Internal Medicine, Georges Pompidou European Hospital
  8. 8UPMC, GRC 08, Pierre Louis Institute of Epidemiology and Public Health – APHP, Department of Rheumatology, Pitié-Salpêtrière Hospital, Paris, France

Abstract

Objectives To validate Fautrel criteria set for classification of adult onset Still's disease (AOSD), and to establish its discriminative performance to that of the Yamaguchi's set.

Methods We retrospectively reviewed the medical charts of 344 patients who had ferritin and glycosylated ferritin measured at the biochemistry laboratory of Bichat Hospital. Medical informations were extracted via a standardized form. All clinical, biological, imaging features were collected, as well as elements in favor of an alternative diagnosis, specifically symptoms suggestive of other immune-mediated inflammatory diseases (IMID) or active infections. Patients were classified as AOSD or control group, according to a predefined procedure including a review by a group of experts for difficult cases. Algorithms corresponding to Fautrel's and Yamaguchi's classification criteria sets were applied for each patient.

Results 49 AOSD and 229 control patients were included. Fautrel's set displayed a sensitivity of 89.8%, a specificity of 97.8%, and positive and negative predictive values of 89.8% and 97.8% respectively. 5 AOSD diagnoses were missed, and accurately classified as AOSD by standard Yamaguchi's set. The standard Yamaguchi's set – without strict application of exclusion criteria – produced a sensitivity of 95.9%, a specificity of 99.6%, and positive and negative predictive values of 97.9% and 99.1% respectively. 2 AOSD diagnoses were missed and correctly classified with the Fautrel's set. If we applied a stricter definition of exclusion criteria, the sensitivity of Yamaguchi's set decreased to 30.6% (p<0.0001). 34 AOSD diagnoses were also missed. These different sets showed excellent performance, although the differences did not reach statistical significance.

Conclusions Both criteria display high discrimination power in a new cohort of cases and controls. The Fautrel criteria set includes glycosylated ferritin and does not require exclusion criteria. The Yamaguchi criteria set is highly impacted by the way the satisfaction of exclusion criteria were performed.

  1. Yamaguchi M, Ohta A, Tsunematsu T, Kasukawa R, Mizushima Y, Kashiwagi H, et al. Preliminary criteria for classification of adult Still's disease. The Journal of rheumatology. 1992;19(3):424–30.

  2. Fautrel B, Zing E, Golmard JL, Le Moel G, Bissery A, Rioux C, et al. Proposal for a new set of classification criteria for adult-onset still disease. Medicine. 2002;81(3):194–200.

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.