Abstract
Objectives To identify measures distinguishing macrophage activation syndrome (MAS) in systemic juvenile idiopathic arthritis (sJIA) from familial hemophagocytic lymphohistiocytosis (FHL) and virus-associated hemophagocytic lymphohistiocytosis (VA-HLH) and to define appropriate cutoff values. To evaluate suggested dynamic measures differentiating MAS in patients with sJIA from sJIA flares.
Study design In a cohort of patients referred for evaluation of hemophagocytic lymphohistiocytosis, we identified 27 patients with sJIA and MAS (MAS/sJIA) fulfilling the criteria of the proposed preliminary diagnostic guideline for the diagnosis of MAS in sJIA. Ten measures at diagnosis were compared between the MAS/sJIA group and 90 patients with FHL and 42 patients with VA-HLH, and cutoff values were determined. In addition, 5 measures were analyzed for significant change from before MAS until MAS diagnosis.
Results Neutrophil count and C-reactive protein were significantly higher in patients with MAS/sJIA compared with patients with FHL and patients with VA-HLH, with 1.8 x 10(9)/L neutrophils (sensitivity 85%, specificity 83%) and 90 mg/L C-reactive protein (74%, 89%) as cutoff values. Soluble CD25
Conclusion Readily available measures can rapidly differentiate between MAS/sJIA and FHL/VA-HLH. The findings substantiate that a decline of measures may facilitate the distinction of MAS from flares of sJIA.
Original language | English |
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Pages (from-to) | 1245-1251 |
Number of pages | 7 |
Journal | The Journal of Pediatrics |
Volume | 162 |
Issue number | 6 |
DOIs | |
Publication status | Published - Jun-2013 |
Externally published | Yes |
Keywords
- KILLER-CELL DYSFUNCTION
- RHEUMATOID-ARTHRITIS
- DISEASE
- DISORDERS
- CHILDREN
- MULTICENTER
- GUIDELINES
- DIAGNOSIS
- SAFETY
- GENE