Tocilizumab modifies clinical and laboratory features of macrophage activation syndrome complicating systemic juvenile idiopathic arthritis

Autor: Mariko Mohri, Masaaki Mori, Yasuo Nakagishi, Hiroyuki Wakiguchi, Hiroaki Umebayashi, Takahiro Yasumi, Noriko Kinjo, Mao Mizuta, Yuka Okura, Tomohiro Kubota, Nami Okamoto, Masaki Shimizu, Junko Yasumura, Naomi Iwata, Kenichi Nishimura, Masato Yashiro
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
lcsh:Diseases of the musculoskeletal system
Classification criteria
Arthritis
Fibrinogen
Gastroenterology
chemistry.chemical_compound
0302 clinical medicine
Systemic juvenile idiopathic arthritis
Immunology and Allergy
Child
biology
Macrophage Activation Syndrome
lcsh:RJ1-570
Tocilizumab
Treatment Outcome
Antirheumatic Agents
Child
Preschool
Female
lipids (amino acids
peptides
and proteins)
hormones
hormone substitutes
and hormone antagonists
Research Article
medicine.drug
musculoskeletal diseases
medicine.medical_specialty
Antibodies
Monoclonal
Humanized
03 medical and health sciences
Rheumatology
Internal medicine
medicine
Humans
Retrospective Studies
030203 arthritis & rheumatology
business.industry
fungi
Expert consensus
lcsh:Pediatrics
Patient data
medicine.disease
Arthritis
Juvenile
body regions
Ferritin
030104 developmental biology
chemistry
Case-Control Studies
Macrophage activation syndrome
Pediatrics
Perinatology and Child Health
biology.protein
lcsh:RC925-935
business
Zdroj: Pediatric Rheumatology Online Journal
Pediatric Rheumatology Online Journal, Vol 18, Iss 1, Pp 1-7 (2020)
ISSN: 1546-0096
Popis: Background This study aimed to determine the influence of tocilizumab (TCZ) in modifying the clinical and laboratory features of macrophage activation syndrome (MAS) complicating systemic juvenile idiopathic arthritis (s-JIA). Furthermore, we assessed the performance of the 2016 MAS classification criteria for patients with s-JIA-associated MAS while treated with TCZ. Methods A panel of 15 pediatric rheumatologists conducted a combination of expert consensus and analysis of real patient data. Clinical and laboratory features of s-JIA-associated MAS in 12 TCZ-treated patients and 18 untreated patients were evaluated. Possible MAS was defined as having characteristic laboratory features but lack of clinical features of MAS, or atypical MAS, or early treatment that prevented full-blown MAS. Results Clinically, the TCZ-treated patients with s-JIA-associated MAS were less likely febrile and had significantly lower ferritin, triglyceride, and CRP levels than the untreated patients with s-JIA-associated MAS. Other laboratory features of MAS including lower platelet counts and lower fibrinogen were more pronounced in TCZ-treated patients. The TCZ-treated patients with s-JIA-associated MAS were less likely to be classified as MAS based on the MAS classification criteria (25% vs 83.3%, p Conclusion TCZ could modify the clinical and laboratory features of s-JIA-associated MAS. When evaluating the s-JIA patients while treated with TCZ, it is not applicable to use MAS classification criteria. Care must be taken to not underdiagnose MAS based on the MAS classification criteria.
Databáze: OpenAIRE
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