Comparison of baseline laboratory findings of macrophage activation syndrome complicating systemic juvenile idiopathic arthritis and multisystem inflammatory syndrome in children. (7th February 2021)

• Record Type: Journal Article
• Authors: Aydın, Fatma; Çelikel, Elif; Ekici Tekin, Zahide; Coşkun, Serkan; Sezer, Müge; Karagöl, Cüneyt; Kaplan, Melike Mehveş; Tekgöz, Nilüfer; Kurt, Tuba; Özcan, Serhan; Kavurt, Ahmet Vedat; Özkaya Parlakay, Aslınur; Çelikel Acar, Banu
• Is Part Of: International journal of rheumatic diseases. Volume 24:Number 4(2021)
• Page Start: 542
• Page End: 547
• Publication Date: 2021-02-07
• Subjects: coronavirus disease 2019 -- cytokine storm syndrome -- macrophage activation syndrome -- multisystem inflammatory syndrome in children; Rheumatology -- Periodicals; Rheumatology -- Asia -- Periodicals; Rheumatology -- Pacific Area -- Periodicals; Rheumatic Diseases -- Periodicals; Connective Tissue Diseases -- Periodicals; Immune System Diseases -- Periodicals; 616.723
• DOI: 10.1111/1756-185X.14078
• Languages: English
• ISSNs: 1756-1841

Abstract

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/mm 3 ) and CRP (194.23 mg/dL) values, but lower absolute lymphocyte count (1140/mm 3 ) 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.