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 |
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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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