Macrophage activation syndrome in patients with systemic juvenile idiopathic arthritis on anti-interleukin-1 or -6 therapy.

Autor:	Ulu K; Department of Pediatric Rheumatology, Ümraniye Training and Research Hospital, İstanbul, Turkey., Aliyev E; Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey., Kılıç Könte E; Department of Pediatric Rheumatology, İstanbul University-Cerrahpasa, İstanbul, Turkey., Tanatar A; Department of Pediatric Rheumatology, İstanbul University, İstanbul, Turkey., Türkmen Ş; Department of Pediatric Rheumatology, Ümraniye Training and Research Hospital, İstanbul, Turkey., Doğantan Ş; Department of Pediatric Rheumatology, Erciyes University, Kayseri, Turkey., Kızıldağ Z; Department of Pediatric Rheumatology, Dokuz Eylül University, İzmir, Turkey., Kasap Demir B; Department of Pediatric Rheumatology, Tepecik Training and Research Hospital, İzmir, Turkey., Gezgin Yıldırım D; Department of Pediatric Rheumatology, Gazi University, Ankara, Turkey., Otar Yener G; Department of Pediatric Rheumatology, Gaziantep Medical Point Hospital, Gaziantep, Turkey., Öztürk K; Department of Pediatric Rheumatology, İstanbul Medeniyet University, İstanbul, Turkey., Baba Ö; Department of Pediatric Rheumatology, Karadeniz Technical University, Trabzon, Turkey., Açarı C; Department of Pediatric Rheumatology, İnönü University, Malatya, Turkey., Kılbaş G; Department of Pediatric Rheumatology, Pamukkale University, Denizli, Turkey., Taşkın SN; Department of Pediatric Rheumatology, Erciyes University, Kayseri, Turkey., Haşlak F; Department of Pediatric Rheumatology, İstanbul University-Cerrahpasa, İstanbul, Turkey., Çağlayan Ş; Department of Pediatric Rheumatology, Ümraniye Training and Research Hospital, İstanbul, Turkey., Bağlan E; Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey., Dundar HA; Department of Pediatric Rheumatology, Van Training and Research Hospital, Van, Turkey., Başaran Ö; Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey., Barut K; Department of Pediatric Rheumatology, İstanbul University-Cerrahpasa, İstanbul, Turkey., Karadağ ŞG; Department of Pediatric Rheumatology, İstanbul University, İstanbul, Turkey., Coşkuner T; Department of Pediatric Rheumatology, Ümraniye Training and Research Hospital, İstanbul, Turkey., Sönmez HE; Department of Pediatric Rheumatology, Kocaeli University, Kocaeli, Turkey., Yüksel S; Department of Pediatric Rheumatology, Pamukkale University, Denizli, Turkey., Kalyoncu M; Department of Pediatric Rheumatology, Karadeniz Technical University, Trabzon, Turkey., Bakkaloğlu SA; Department of Pediatric Rheumatology, Gazi University, Ankara, Turkey., Ünsal E; Department of Pediatric Rheumatology, Dokuz Eylül University, İzmir, Turkey., Paç Kısaarslan A; Department of Pediatric Rheumatology, Erciyes University, Kayseri, Turkey., Bilginer Y; Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey., Aktay Ayaz N; Department of Pediatric Rheumatology, İstanbul University, İstanbul, Turkey., Kasapçopur Ö; Department of Pediatric Rheumatology, İstanbul University-Cerrahpasa, İstanbul, Turkey., Özen S; Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey., Sözeri B; Department of Pediatric Rheumatology, Ümraniye Training and Research Hospital, İstanbul, Turkey.
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2024 Sep 01; Vol. 63 (SI2), pp. SI167-SI172.
DOI:	10.1093/rheumatology/keae124
Abstrakt:	Objectives: The aim of this study is to investigate the effect of anti-interleukin (IL)-1/-6 biologics on systemic juvenile idiopathic arthritis (sJIA)-associated macrophage activation syndrome (MAS). Methods: Demographic, clinical and laboratory data of patients followed up with a diagnosis of sJIA-associated MAS assessed from sixteen paediatric rheumatology centres across the country. The clinical and laboratory features of MAS developing while on biological drugs were compared with those without this treatment. Results: One hundred and sixty-two patients were included in the study. Forty-five of the MAS events were detected under the effect of anti-IL-1/-6 biologics, while the patients experiencing the remaining 155 events have not received biological treatment in the last three months. Platelet count [128 (72-232) vs 199 (130-371) 109/l], ferritin level on admission [1107 (676-2050) vs 2863 (1193-9562) ng/ml], C-reactive protein level [15.4 (2.9-56) vs 90 (32-160) mg/l], erythrocyte sedimentation rate [13 (3-36) vs 43.5 (13-77) mm/h] and fever duration [5 (4-7.5) vs 10 (7-14.3) days] were found lower in the group under the impact of anti-IL-1/-6 biologics. Among patients treated with biologics, 26.6% did not meet the published 2016 MAS classification criteria at presentation. The rates of hepatomegaly and splenomegaly were relatively lower in the canakinumab-treated group when compared with those receiving other biologicals or to patients, not on biologicals. Conclusion: Anti-IL-1/-6 therapies can mask the clinical and laboratory features of MAS, and proposed guidelines for MAS classification criteria may not be met. (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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