From the Guidelines
Yes, a hematologist can order an Interleukin-18 (IL-18) and Interleukin-1 beta (IL-1beta) test, as these biomarkers are relevant in the diagnosis and management of certain conditions, such as Still's disease, which may involve hematological manifestations.
Relevant Biomarkers
- IL-18 and S100 proteins are considered candidate diagnostic biomarkers for Still's disease, with marked elevation of serum IL-18 and/or S100 proteins strongly supporting the diagnosis 1.
- IL-18 is also a candidate biomarker for macrophage activation syndrome (MAS), a severe complication of Still's disease 1.
Clinical Context
- The diagnosis of Still's disease relies on a combination of clinical and biological findings, and IL-18 and IL-1beta tests may be useful in supporting the diagnosis, particularly in cases where the diagnosis is uncertain 1.
- The use of IL-1 and IL-6 inhibitors has dramatically changed the outcome of patients with Still's disease, and the measurement of IL-18 and other biomarkers may help guide treatment decisions 1.
Limitations and Future Directions
- While IL-18 and IL-1beta tests may be useful in certain clinical contexts, there is currently no consensual or validated threshold for these biomarkers, and further research is needed to establish their role in clinical practice 1.
- The development of validated diagnostic biomarkers, including IL-18 and S100 proteins, is an area of ongoing research, with the aim of improving the diagnosis and management of Still's disease and its complications 1.
From the Research
Hematologist's Role in Ordering IL-18 and IL-1beta Tests
- A hematologist is a medical doctor who specializes in the diagnosis, treatment, and prevention of blood disorders [(2,3,4,5,6)].
- While the provided studies discuss the role of IL-18 and IL-1beta in various diseases, including inflammatory and autoimmune diseases [(2,3)], they do not specifically address the role of hematologists in ordering these tests.
- However, based on the studies, it can be inferred that hematologists may be involved in the diagnosis and treatment of diseases that involve IL-18 and IL-1beta, such as rheumatoid arthritis and other inflammatory diseases [(2,3)].
- As part of their diagnostic workup, hematologists may order tests to measure IL-18 and IL-1beta levels in patients, especially if they suspect an underlying inflammatory or autoimmune condition [(4,5,6)].
IL-18 and IL-1beta Tests
- The studies provide information on the biological properties and pathological roles of IL-18 and IL-1beta in various diseases [(2,3,4,5,6)].
- However, they do not provide specific guidance on who can order IL-18 and IL-1beta tests or under what circumstances these tests should be ordered.
- In general, the decision to order any medical test, including IL-18 and IL-1beta tests, would depend on the patient's clinical presentation, medical history, and the suspected underlying condition [(2,3,4,5,6)].