The Use of Chitotriosidase as a Marker of Active Sarcoidosis and in the Diagnosis of Fever of Unknown Origin (FUO)

Sarcoidosis is a multi-organ inflammatory granulomatosis with a lung-predominant involvement. The aim of this study was to investigate the use of serum chitotriosidase (CHIT1) in patients with fever of unknown origin (FUO); the patients with confirmed diagnosis of active sarcoidosis were compared wi...

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Autores principales:	Angela Maria Di Francesco, Elena Verrecchia, Ludovico Luca Sicignano, Maria Grazia Massaro, Daniela Antuzzi, Marcello Covino, Giuliana Pasciuto, Luca Richeldi, Raffaele Manna
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	sarcoidosis chitotriosidase biomarkers FUO Medicine R
Acceso en línea:	https://doaj.org/article/e7814f8b9a0243c1aaa814a608c73587
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spelling	oai:doaj.org-article:e7814f8b9a0243c1aaa814a608c735872021-11-25T18:01:20ZThe Use of Chitotriosidase as a Marker of Active Sarcoidosis and in the Diagnosis of Fever of Unknown Origin (FUO)10.3390/jcm102252832077-0383https://doaj.org/article/e7814f8b9a0243c1aaa814a608c735872021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5283https://doaj.org/toc/2077-0383Sarcoidosis is a multi-organ inflammatory granulomatosis with a lung-predominant involvement. The aim of this study was to investigate the use of serum chitotriosidase (CHIT1) in patients with fever of unknown origin (FUO); the patients with confirmed diagnosis of active sarcoidosis were compared with ones affected by inactive or treated sarcoidosis. CHIT1 activity was evaluated in 110 patients initially admitted at the hospital as FUOs. The overall performance of CHIT1 for active sarcoidosis diagnosis was assessed by performing an area under the receiver operating characteristic curve analysis (AUROC). The sarcoidosis patients were significantly older than the FUO patients not affected by sarcoidosis (<i>p</i> < 0.01). CHIT1 showed a good accuracy as a biomarker for active sarcoidosis in patients explored for FUO (AUROC 0.955; CI 95% 0.895–0.986; <i>p</i> < 0.001). A CHIT1 value >90.86 showed 96.8% sensitivity (84.2–99.9) and 85.5% specificity (75–92.8) in discriminating active sarcoidosis from other causes of FUO. CHIT1 significantly discriminated active versus inactive/under treatment sarcoidosis patients (with lower enzyme activity) (ROC analysis, sensitivity: 96.9%, specificity: 94.7%, value >83.01 nmol/mL/h, AUROC: 0.958, 0.862–0.994, <i>p</i> < 0.001) compared to ACE (ROC analysis, sensitivity: 25.8%, specificity: 93.7%, value >65 UI/L). In conclusion, CHIT1 is a reliable/sensitive biomarker of active sarcoidosis, with values significantly decreasing in remitted/treated patients. It significantly discriminates active sarcoidosis from FUO patients, providing a useful tool in the diagnosis-assessing process.Angela Maria Di FrancescoElena VerrecchiaLudovico Luca SicignanoMaria Grazia MassaroDaniela AntuzziMarcello CovinoGiuliana PasciutoLuca RicheldiRaffaele MannaMDPI AGarticlesarcoidosischitotriosidasebiomarkersFUOMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5283, p 5283 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	sarcoidosis chitotriosidase biomarkers FUO Medicine R
spellingShingle	sarcoidosis chitotriosidase biomarkers FUO Medicine R Angela Maria Di Francesco Elena Verrecchia Ludovico Luca Sicignano Maria Grazia Massaro Daniela Antuzzi Marcello Covino Giuliana Pasciuto Luca Richeldi Raffaele Manna The Use of Chitotriosidase as a Marker of Active Sarcoidosis and in the Diagnosis of Fever of Unknown Origin (FUO)
description	Sarcoidosis is a multi-organ inflammatory granulomatosis with a lung-predominant involvement. The aim of this study was to investigate the use of serum chitotriosidase (CHIT1) in patients with fever of unknown origin (FUO); the patients with confirmed diagnosis of active sarcoidosis were compared with ones affected by inactive or treated sarcoidosis. CHIT1 activity was evaluated in 110 patients initially admitted at the hospital as FUOs. The overall performance of CHIT1 for active sarcoidosis diagnosis was assessed by performing an area under the receiver operating characteristic curve analysis (AUROC). The sarcoidosis patients were significantly older than the FUO patients not affected by sarcoidosis (<i>p</i> < 0.01). CHIT1 showed a good accuracy as a biomarker for active sarcoidosis in patients explored for FUO (AUROC 0.955; CI 95% 0.895–0.986; <i>p</i> < 0.001). A CHIT1 value >90.86 showed 96.8% sensitivity (84.2–99.9) and 85.5% specificity (75–92.8) in discriminating active sarcoidosis from other causes of FUO. CHIT1 significantly discriminated active versus inactive/under treatment sarcoidosis patients (with lower enzyme activity) (ROC analysis, sensitivity: 96.9%, specificity: 94.7%, value >83.01 nmol/mL/h, AUROC: 0.958, 0.862–0.994, <i>p</i> < 0.001) compared to ACE (ROC analysis, sensitivity: 25.8%, specificity: 93.7%, value >65 UI/L). In conclusion, CHIT1 is a reliable/sensitive biomarker of active sarcoidosis, with values significantly decreasing in remitted/treated patients. It significantly discriminates active sarcoidosis from FUO patients, providing a useful tool in the diagnosis-assessing process.
format	article
author	Angela Maria Di Francesco Elena Verrecchia Ludovico Luca Sicignano Maria Grazia Massaro Daniela Antuzzi Marcello Covino Giuliana Pasciuto Luca Richeldi Raffaele Manna
author_facet	Angela Maria Di Francesco Elena Verrecchia Ludovico Luca Sicignano Maria Grazia Massaro Daniela Antuzzi Marcello Covino Giuliana Pasciuto Luca Richeldi Raffaele Manna
author_sort	Angela Maria Di Francesco
title	The Use of Chitotriosidase as a Marker of Active Sarcoidosis and in the Diagnosis of Fever of Unknown Origin (FUO)
title_short	The Use of Chitotriosidase as a Marker of Active Sarcoidosis and in the Diagnosis of Fever of Unknown Origin (FUO)
title_full	The Use of Chitotriosidase as a Marker of Active Sarcoidosis and in the Diagnosis of Fever of Unknown Origin (FUO)
title_fullStr	The Use of Chitotriosidase as a Marker of Active Sarcoidosis and in the Diagnosis of Fever of Unknown Origin (FUO)
title_full_unstemmed	The Use of Chitotriosidase as a Marker of Active Sarcoidosis and in the Diagnosis of Fever of Unknown Origin (FUO)
title_sort	use of chitotriosidase as a marker of active sarcoidosis and in the diagnosis of fever of unknown origin (fuo)
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/e7814f8b9a0243c1aaa814a608c73587
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The Use of Chitotriosidase as a Marker of Active Sarcoidosis and in the Diagnosis of Fever of Unknown Origin (FUO)

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