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Comparative Study
. 2021 Apr;24(4):542-547.
doi: 10.1111/1756-185X.14078. Epub 2021 Feb 7.

Comparison of baseline laboratory findings of macrophage activation syndrome complicating systemic juvenile idiopathic arthritis and multisystem inflammatory syndrome in children

Fatma Aydın  1 , Elif Çelikel  1 , Zahide Ekici Tekin  1 , Serkan Coşkun  1 , Müge Sezer  1 , Cüneyt Karagöl  1 , Melike Mehveş Kaplan  1 , Nilüfer Tekgöz  1 , Tuba Kurt  1 , Serhan Özcan  2 , Ahmet Vedat Kavurt  3 , Aslınur Özkaya Parlakay  4 , Banu Çelikel Acar  1
Affiliations
Comparative Study

Comparison of baseline laboratory findings of macrophage activation syndrome complicating systemic juvenile idiopathic arthritis and multisystem inflammatory syndrome in children

Fatma Aydın et al. Int J Rheum Dis. 2021 Apr.

Abstract

Aims: Recently, multisystem inflammatory syndrome in children (MIS-C) has been recognized in association with coronavirus disease 2019 as a cytokine storm syndrome. MIS-C presents with symptoms similar to Kawasaki disease and macrophage activation syndrome (MAS). We aimed to better understand this cytokine storm syndrome by comparing the initial laboratory findings of MIS-C and MAS.

Methods: Patients who were diagnosed with MAS due to systemic juvenile idiopathic arthritis in our clinic between March 2002 and November 2020 and with MIS-C between 20 September and 20 October 2020 were enrolled into the study. The medical files of all patients were reviewed retrospectively.

Results: A total of 13 MAS (9 boys, 4 girls) and 26 MIS-C (16 boys,10 girls) patients were included in the study. Hemoglobin, absolute neutrophil and lymphocyte counts, C-reactive protein (CRP), ferritin, fibrinogen and lactate dehydrogenase (LDH) levels showed significant differences between the two groups (P < 0.05). Patients with MAS had lower hemoglobin (10.10 g/dL) and fibrinogen (2.72 g/dL), but higher ferritin (17 863 mg/dL) and LDH (890.61 U/L) at the time of diagnosis. Patients with MIS-C had higher absolute neutrophil count (12 180/mm3 ) and CRP (194.23 mg/dL) values, but lower absolute lymphocyte count (1140/mm3 ) at the time of diagnosis. Left ventricle ejection fraction was significantly lower in the MIS-C group in echocardiographic evaluation (P < 0.001).

Conclusion: Ferritin, hemoglobin, LDH, and fibrinogen levels were significantly changed in MAS compared with MIS-C. However, patients with MIS-C have more severe signs than MAS, such as cardiac involvement.

Keywords: coronavirus disease 2019; cytokine storm syndrome; macrophage activation syndrome; multisystem inflammatory syndrome in children.

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References

REFERENCES

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