Evaluation of clinical biomarkers for differential diagnosis of intravascular lymphoma and Still’s disease

Abstract Intravascular lymphoma (IVL) and Still’s disease are rare conditions that present with overlapping systemic symptoms, including persistent fever and inflammatory responses, making differential diagnosis challenging. Misdiagnosis can lead to delays in appropriate treatment, which is particul...

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Main Authors: Takahiro Shima, Yusuke Yamauchi, Masahiro Ohtsu, Hiroki Mitoma, Koichi Akashi, Koji Kato
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-09401-4
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author Takahiro Shima
Yusuke Yamauchi
Masahiro Ohtsu
Hiroki Mitoma
Koichi Akashi
Koji Kato
author_facet Takahiro Shima
Yusuke Yamauchi
Masahiro Ohtsu
Hiroki Mitoma
Koichi Akashi
Koji Kato
author_sort Takahiro Shima
collection DOAJ
description Abstract Intravascular lymphoma (IVL) and Still’s disease are rare conditions that present with overlapping systemic symptoms, including persistent fever and inflammatory responses, making differential diagnosis challenging. Misdiagnosis can lead to delays in appropriate treatment, which is particularly critical for IVL due to its aggressive nature. This retrospective cohort study aimed to identify clinically useful biomarkers for distinguishing IVL from Still’s disease. IVL and Still’s disease patients were analyzed alongside healthy controls. Laboratory assessments included serum ferritin, soluble interleukin-2 receptor (sIL-2R), and interleukin-18 (IL-18) levels. Ferritin levels were significantly higher in Still’s disease, while sIL-2R levels were markedly elevated in IVL. IL-18 levels were significantly higher in Still’s disease than in IVL, distinguishing the inflammatory profile of each disease. Receiver operating characteristic curve analysis demonstrated excellent discriminatory power, with sIL-2R and IL-18 achieving an area under the curve. These findings suggest that ferritin, sIL-2R, and IL-18 serve as potential biomarkers in differentiating IVL from Still’s disease. Their incorporation into clinical practice may facilitate early and accurate diagnosis, reducing the risk of misdiagnosis and improving patient outcomes. Further large-scale studies are warranted to validate these results.
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spelling doaj-art-7b668bc218e94ce3b1f9d0f9f71ef9642025-08-20T03:03:42ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-09401-4Evaluation of clinical biomarkers for differential diagnosis of intravascular lymphoma and Still’s diseaseTakahiro Shima0Yusuke Yamauchi1Masahiro Ohtsu2Hiroki Mitoma3Koichi Akashi4Koji Kato5Department of Medicine and Biosystemic Science, Kyushu University Graduate School of MedicineDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of MedicineDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of MedicineDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of MedicineDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of MedicineDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of MedicineAbstract Intravascular lymphoma (IVL) and Still’s disease are rare conditions that present with overlapping systemic symptoms, including persistent fever and inflammatory responses, making differential diagnosis challenging. Misdiagnosis can lead to delays in appropriate treatment, which is particularly critical for IVL due to its aggressive nature. This retrospective cohort study aimed to identify clinically useful biomarkers for distinguishing IVL from Still’s disease. IVL and Still’s disease patients were analyzed alongside healthy controls. Laboratory assessments included serum ferritin, soluble interleukin-2 receptor (sIL-2R), and interleukin-18 (IL-18) levels. Ferritin levels were significantly higher in Still’s disease, while sIL-2R levels were markedly elevated in IVL. IL-18 levels were significantly higher in Still’s disease than in IVL, distinguishing the inflammatory profile of each disease. Receiver operating characteristic curve analysis demonstrated excellent discriminatory power, with sIL-2R and IL-18 achieving an area under the curve. These findings suggest that ferritin, sIL-2R, and IL-18 serve as potential biomarkers in differentiating IVL from Still’s disease. Their incorporation into clinical practice may facilitate early and accurate diagnosis, reducing the risk of misdiagnosis and improving patient outcomes. Further large-scale studies are warranted to validate these results.https://doi.org/10.1038/s41598-025-09401-4Intravascular lymphomaStill’s diseaseFerritinsIL-2RIL-18
spellingShingle Takahiro Shima
Yusuke Yamauchi
Masahiro Ohtsu
Hiroki Mitoma
Koichi Akashi
Koji Kato
Evaluation of clinical biomarkers for differential diagnosis of intravascular lymphoma and Still’s disease
Scientific Reports
Intravascular lymphoma
Still’s disease
Ferritin
sIL-2R
IL-18
title Evaluation of clinical biomarkers for differential diagnosis of intravascular lymphoma and Still’s disease
title_full Evaluation of clinical biomarkers for differential diagnosis of intravascular lymphoma and Still’s disease
title_fullStr Evaluation of clinical biomarkers for differential diagnosis of intravascular lymphoma and Still’s disease
title_full_unstemmed Evaluation of clinical biomarkers for differential diagnosis of intravascular lymphoma and Still’s disease
title_short Evaluation of clinical biomarkers for differential diagnosis of intravascular lymphoma and Still’s disease
title_sort evaluation of clinical biomarkers for differential diagnosis of intravascular lymphoma and still s disease
topic Intravascular lymphoma
Still’s disease
Ferritin
sIL-2R
IL-18
url https://doi.org/10.1038/s41598-025-09401-4
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