Case Report: Macrophage Activation Syndrome and Widespread Neuroimaging Abnormality in Childhood-Onset Systemic Lupus Erythematosus

被引：3

作者：

Shi, Nana ^{[1
]}

Wang, Xiangying ^{[2
]}

Zou, Lixia ^{[3
]}

Yang, Xinghui ^{[4
]}

Ma, Qian ^{[3
]}

Lu, Meiping ^{[3
]}

机构：

[1] Zhejiang Univ, Sch Med, Natl Clin Res Ctr Child Hlth, Dept Hematol Oncol,Children Hosp, Hangzhou, Peoples R China

[2] Hangzhou Children Hosp, Hangzhou, Peoples R China

[3] Zhejiang Univ, Sch Med, Natl Clin Res Ctr Child Hlth, Dept Rheumatol Immunol & Allergy,Children Hosp, Hangzhou, Peoples R China

[4] Zhejiang Univ, Sch Med, Natl Clin Res Ctr Child Hlth, Dept Radiol,Children Hosp, Hangzhou, Peoples R China

来源：

FRONTIERS IN PEDIATRICS | 2021年 / 9卷

关键词：

macrophage activation syndrome; systemic lupus erythematosus; central nervous system; neuroimaging; pediatric; JUVENILE IDIOPATHIC ARTHRITIS; CLINICAL-FEATURES; NEUROPSYCHIATRIC EVENTS; HEMOPHAGOCYTIC SYNDROME; CHILDREN; MULTICENTER; DIAGNOSIS; DISEASE;

D O I：

10.3389/fped.2021.767115

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Macrophage activation syndrome (MAS) and widespread brain lesions are rare and severe complications of childhood-onset systemic lupus erythematosus (SLE). We report an 11-year-old girl who presented with recurrent rashes for half a year and fever for 2 weeks. Clinical and laboratory features at admission pointed to the diagnosis of SLE and SLE-associated MAS. Cerebral magnetic resonance imaging taken on day 4 after admission showed abnormal signals. Glucocorticoid therapy was started on day 5. Two days later, the patient appeared weak and ill, then the next day she exhibited dizziness, drowsiness, apathia, and dysarthria. High-dose methylprednisolone, cyclophosphamide, and intravenous immunoglobulin were used to treat the patient, and intrathecal dexamethasone was given. The patient was discharged on day 30 after admission and showed complete clinical resolution and improved magnetic resonance imaging resolution.

引用

页数：5

共 23 条

[11] Macrophage activation syndrome: A severe and frequent manifestation of acute pancreatitis in 362 childhood-onset compared to 1830 adult-onset systemic lupus erythematosus patients [J].

Gormezano, Natali W. S. ;

Otsuzi, Carini I. ;

Barros, Diego L. ;

da Silva, Mariana A. ;

Pereira, Rosa M. R. ;

Campos, Lucia M. A. ;

Borba, Eduardo F. ;

Bonfa, Eloisa ;

Silva, Clovis A. .

SEMINARS IN ARTHRITIS AND RHEUMATISM, 2016, 45 (06) :706-710

[12] Experience With Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome at a Single Institution [J].

Gupta, Abha A. ;

Tyrell, Pascal ;

Valani, Rahim ;

Benseler, Susanne ;

Adelhaleem, Mohamed ;

Weitzman, Sheila .

JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY, 2009, 31 (02) :81-84

[13] Neuropsychiatric events in systemic lupus erythematosus: a longitudinal analysis of outcomes in an international inception cohort using a multistate model approach [J].

Hanly, John G. ;

Urowitz, Murray B. ;

Gordon, Caroline ;

Bae, Sang-Cheol ;

Romero-Diaz, Juanita ;

Sanchez-Guerrero, Jorge ;

Bernatsky, Sasha ;

Clarke, Ann E. ;

Wallace, Daniel J. ;

Isenberg, David A. ;

Rahman, Anisur ;

Merrill, Joan T. ;

Fortin, Paul R. ;

Gladman, Dafna D. ;

Bruce, Ian N. ;

Petri, Michelle ;

Ginzler, Ellen M. ;

Dooley, Mary Anne ;

Ramsey-Goldman, Rosalind ;

Manzi, Susan ;

Jonsen, Andreas ;

Alarcon, Graciela S. ;

van Vollenhoven, Ronald F. ;

Aranow, Cynthia ;

Mackay, Meggan ;

Ruiz-Rastorza, Guillermo ;

Lim, Sam ;

Inanc, Murat ;

Kalunian, Kenneth C. ;

Jacobsen, Soren ;

Peschken, Christine A. ;

Kamen, Diane L. ;

Askanase, Anca ;

Farewell, Vernon .

ANNALS OF THE RHEUMATIC DISEASES, 2020, 79 (03) :356-362

[14] How to Treat Involvement of the Central Nervous System in Hemophagocytic Lymphohistiocytosis? [J].

Horne, AnnaCarin ;

Wickstrom, Ronny ;

Jordan, Michael B. ;

Yeh, E. Ann ;

Naqvi, Ahmed ;

Henter, Jan-Inge ;

Janka, Gritta .

CURRENT TREATMENT OPTIONS IN NEUROLOGY, 2017, 19 (01)

[15] Macrophage activation syndrome: early diagnosis is key [J].

Lerkvaleekul, Butsabong ;

Vilaiyuk, Soamarat .

OPEN ACCESS RHEUMATOLOGY-RESEARCH AND REVIEWS, 2018, 10 :117-128

[16] Severe macrophage activation syndrome and central nervous system involvement in juvenile dermatomyositis [J].

Lilleby, V. ;

Haydon, J. ;

Sanner, H. ;

Krossness, B. K. ;

Ringstad, G. ;

Flato, B. .

SCANDINAVIAN JOURNAL OF RHEUMATOLOGY, 2014, 43 (02) :171-173

[17] MRI findings of central nervous system involvement in children with haemophagocytic lymphohistiocytosis: correlation with clinical biochemical tests [J].

Ma, W. ;

Li, X. J. ;

Li, W. ;

Xiao, L. ;

Ji, X. J. ;

Xu, Y. .

CLINICAL RADIOLOGY, 2021, 76 (02) :159.e9-159.e17

[18] Clinical Features, Treatment, and Outcome of Macrophage Activation Syndrome Complicating Systemic Juvenile Idiopathic Arthritis A Multinational, Multicenter Study of 362 Patients [J].

Minoia, Francesca ;

Davi, Sergio ;

Horne, AnnaCarin ;

Demirkaya, Erkan ;

Bovis, Francesca ;

Li, Caifeng ;

Lehmberg, Kai ;

Weitzman, Sheila ;

Insalaco, Antonella ;

Wouters, Carine ;

Shenoi, Susan ;

Espada, Graciela ;

Ozen, Seza ;

Anton, Jordi ;

Khubchandani, Raju ;

Russo, Ricardo ;

Pal, Priyankar ;

Kasapcopur, Ozgur ;

Miettunen, Paivi ;

Maritsi, Despoina ;

Merino, Rosa ;

Shakoory, Bita ;

Alessio, Maria ;

Chasnyk, Vyacheslav ;

Sanner, Helga ;

Gao, Yi-Jin ;

Zeng Huasong ;

Kitoh, Toshiyuki ;

Avcin, Tadej ;

Fischbach, Michel ;

Frosch, Michael ;

Grom, Alexei ;

Huber, Adam ;

Jelusic, Marija ;

Sawhney, Sujata ;

Uziel, Yosef ;

Ruperto, Nicolino ;

Martini, Alberto ;

Cron, Randy Q. ;

Ravelli, Angelo .

ARTHRITIS & RHEUMATOLOGY, 2014, 66 (11) :3160-3169

[19] Macrophage Activation Syndrome in Juvenile Systemic Lupus Erythematosus A Multinational Multicenter Study of Thirty-Eight Patients [J].

Parodi, Alessandro ;

Davi, Sergio ;

Beatriz Pringe, Alejandra ;

Pistorio, Angela ;

Ruperto, Nicolino ;

Magni-Manzoni, Silvia ;

Miettunen, Paivi ;

Bader-Meunier, Brigitte ;

Espada, Graciela ;

Sterba, Gary ;

Ozen, Seza ;

Wright, Dowain ;

Magalhaes, Claudia Saad ;

Khubchandani, Raju ;

Michels, Hartmut ;

Woo, Patricia ;

Iglesias, Antonio ;

Guseinova, Dinara ;

Bracaglia, Claudia ;

Hayward, Kristen ;

Wouters, Carine ;

Grom, Alexei ;

Vivarelli, Marina ;

Fischer, Alberto ;

Breda, Luciana ;

Martini, Alberto ;

Ravelli, Angelo .

ARTHRITIS AND RHEUMATISM, 2009, 60 (11) :3388-3399

[20] Magnetic resonance imaging in neuropsychiatric systemic lupus erythematosus: current state of the art and novel approaches [J].

Postal, M. ;

Lapa, A. Tamires ;

Reis, F. ;

Rittner, L. ;

Appenzeller, S. .

LUPUS, 2017, 26 (05) :517-521

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