{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T11:23:56Z","timestamp":1777807436519,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,3,12]],"date-time":"2015-03-12T00:00:00Z","timestamp":1426118400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":173,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"name":"A Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions","award":["JX10231801"],"award-info":[{"award-number":["JX10231801"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81070456, 81270652, 81170490"],"award-info":[{"award-number":["81070456, 81270652, 81170490"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"\u201cLiu Da Ren Cai Gao Feng????? of Jiangsu Province","award":["2010-WS-019"],"award-info":[{"award-number":["2010-WS-019"]}]}],"content-domain":{"domain":["wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Hemophagocytic lymphohistiocytosis (<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>) is a severe hyperinflammatory condition caused by activated T cells and macrophages. Adenosine deaminase (<jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content>) plays an important role in immune regulation, especially in the proliferation, maturation, and differentiation of lymphocytes. Its role has been studied in inflammation and malignancy. Here, we present for the first time the alteration of <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> in secondary <jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">sHLH<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Serum <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> levels were measured in 20 cases with lymphoma\u2010associated hemophagocytic syndrome (<jats:styled-content style=\"fixed-case\">LAHS<\/jats:styled-content>), 15 with infection\u2010associated hemophagocytic syndrome (<jats:styled-content style=\"fixed-case\">IAHS<\/jats:styled-content>), six with macrophage activation syndrome (<jats:styled-content style=\"fixed-case\">MAS<\/jats:styled-content>) as experimental group. Additionally, we enrolled 20 cases with lymphoma, 15 with infection, six with autoimmunity who were all not associated with <jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content> as conditional control group and 20 healthy subjects as blank group. We also demonstrated the <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> levels in 20 <jats:styled-content style=\"fixed-case\">LAHS<\/jats:styled-content> cases and 21 benign disease\u2010associated <jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content> cases (<jats:styled-content style=\"fixed-case\">IAHS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MAS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Serum <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> levels were significantly higher in patients with <jats:styled-content style=\"fixed-case\">LAHS<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> IAHS<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">MAS<\/jats:styled-content> compared to the healthy subjects (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001) and conditional control group (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05). Serum <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> levels of patients with <jats:styled-content style=\"fixed-case\">LAHS<\/jats:styled-content> were significantly higher than benign disease\u2010associated <jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content> cases (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05). The optimum <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> cutoff point for <jats:styled-content style=\"fixed-case\">LAHS<\/jats:styled-content> was 89.25\u00a0U\/L, with a sensitivity and specificity of 85.0% and 76.2%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Serum <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> levels were increased in <jats:styled-content style=\"fixed-case\">sHLH<\/jats:styled-content> suggesting a partial role of activated T\u2010cell response in the disease pathophysiology. Serum <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> levels were particularly higher in <jats:styled-content style=\"fixed-case\">LAHS<\/jats:styled-content> and probably be a potential indicator of underlying lymphoma in <jats:styled-content style=\"fixed-case\">sHLH<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijlh.12334","type":"journal-article","created":{"date-parts":[[2015,3,12]],"date-time":"2015-03-12T10:23:32Z","timestamp":1426155812000},"page":"544-550","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Elevated serum adenosine deaminase levels in secondary hemophagocytic lymphohistiocytosis"],"prefix":"10.1111","volume":"37","author":[{"given":"W.","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Hematology the Affiliated jiangyin Hospital of Southeast University Medical College Jiangyin Jiangsu Province China"},{"name":"Department of Hematology the First Affiliated Hospital of Nanjing Medical University Jiangsu Province Hospital Nanjing Jiangsu Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology the First Affiliated Hospital of Nanjing Medical University Jiangsu Province Hospital Nanjing Jiangsu Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology the First Affiliated Hospital of Nanjing Medical University Jiangsu Province Hospital Nanjing Jiangsu Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"X.","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Hematology the First Affiliated Hospital of Nanjing Medical University Jiangsu Province Hospital Nanjing Jiangsu Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Hematology the First Affiliated Hospital of Nanjing Medical University Jiangsu Province Hospital Nanjing Jiangsu Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Hematology the First Affiliated Hospital of Nanjing Medical University Jiangsu Province Hospital Nanjing Jiangsu Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"X.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology the First Affiliated Hospital of Nanjing Medical University Jiangsu Province Hospital Nanjing Jiangsu Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology the First 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