Clinical usefulness of serum neopterin in children with juvenile idiopathic arthritis

Abstract

Abstract The aim of this study was to analyze the usefulness of the serum concentration of neopterin (NPT) as a marker of juvenile idiopathic arthritis (JIA). The study included 67 children with JIA (36 girls and 31 boys), aged between 3.8 and 17.9 years (mean 13.7±3.4 years), and 105 healthy controls (47 girls and 58 boys) of similar age, with no evidence of acute or chronic inflammation. Serum NPT was determined immunoenzymatically. The median serum concentration of NPT and prevalence of elevated serum NPT (>11 nmol/L) were significantly higher in children with JIA than in the controls: 6.044 vs. 4.734 nmol/L (p<0.001) and 30% vs. 5% (p<0.001), respectively. The serum concentration of NPT did not correlate with body temperature (R=0.00, p=0.97), erythrocyte sedimentation rate (R=0.09, p=0.47), leukocyte count (R=−0.05, p=0.70), C-reactive protein (R=−0.14, p=0.25), and procalcitonin levels (R=0.07, p=0.56). Furthermore, serum NPT was not associated with the type of JIA. However, children with exacerbation of JIA presented with significantly higher median serum level of NPT (10.912 vs. 4.471 nmol/L, p<0.001) and higher prevalence of serum NPT >11 nmol/L (50% vs. 0%, p<0.001) than did patients with remission. These data suggest that elevated serum concentration of NPT is an accurate marker of JIA exacerbation.