Comparison of Adenosine Deaminase Level in Serum and Synovial Fluid in Patients With Juvenile Idiopathic Arthritis and Its Relation to Inflammatory Acute Phase Reactants Publisher



Rahmani K^{1, 2} ; Raeeskarami SR^{3, 4} ; Ziaee V^{3, 4, 5} ; Sadeghi P⁴ ; Moradinejad MH^{1, 4, 5} ; Haghiashtiani MT^{1, 6}
Source: Iranian Journal of Pediatrics Published:2017

Abstract

Background: In JIA, cell-mediated immune response results in secretion of different inflammatory products from activated lym-phocytes, macrophages, fibroblasts and leukocytes in synovial joints. Adenosine deaminase (ADA) regulates this immune system activity by metabolizing adenosine through purine metabolic pathway. Objectives: The aim of this study was to compare the level of serum ADA with synovial fluid ADA in JIA patients and to see whether it can be utilized as a marker for the activity of the disease Methods: JIA was diagnosed based on International League of Associations for Rheumatology diagnosis criteria. ADA was measured using special kits. Results: 80% of the patients had oligoarticular and 20% polarticulare JIA. There was a significant relation between erythrocyte sedimentation rate (ESR) and high level of synovial fluid ADA. Synovial ADA level was significantly higher than serum ADA in polyarticular JIA. C-reactive protein (CRP), leukocytes and platelets count were increased in high levels of synovial fluid ADA. No correlation was observed between level of serum and synovial fluid ADA. Conclusions: Synovial fluid ADA seems a more precise index than serum ADA to assess the inflammatory condition. In addition, acute-phase response reactants such as ESR, CRP, and platelets count could be suitable predicting parameters for arthritis. © 2017, Iranian Journal of Pediatrics.