Secondary macrophage activation syndrome due to autoimmune, hematologic, infectious and oncologic diseases. Thirteen case series and review of the literature

Reumatol Clin. 2015 May-Jun;11(3):139-43. doi: 10.1016/j.reuma.2014.06.007. Epub 2014 Nov 22.

Abstract

Objective: Describe the demographic characteristics and disorders of patients with diagnosis of Macrophage Activation Syndrome (MAS) in the December 2008 - January 2014 period.

Methods: Medical records were reviewed from diagnosis of MAS and after discharge until January 2014. Patients were divided into 4 groups according to the primary disease: Autoimmune (AI), Hemato - oncologic (HO), Infectious (Inf) and Oncologic (Onc). The variables were analyzed among the 4 groups and between AI and HO.

Results: Thirteen patients [7 men, with a median of 54 years (32-63)] were studied. The etiologies were: 5 AI, 5 HO, 2 Inf. and 1 Onc. disease. Hemophagocitc cells were found in the ascitic fluid of one patient. A patient with MAS secondary to IgG4-related disease was found.

Conclusions: Mortality, prognosis and disease progression may be influenced by the delay in diagnosis, treatment initiation and etiology of MAS. HO ill patients had a worse prognosis.

Keywords: Células hemofagocíticas; Hemofagocitosis; Hemophagocytic cells; Hemophagocytic syndrome; Hemophagocytosis; Linfohistiocitocis hemofagocítica; Linfohistiocitocis hemophagocytic; Macrophage activation syndrome; Síndrome de activación macrofágica; Síndrome hemofagocítico.

MeSH terms

  • Adult
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / diagnosis
  • Disease Progression
  • Female
  • Hematologic Diseases / complications*
  • Hematologic Diseases / diagnosis
  • Humans
  • Infections / complications*
  • Infections / diagnosis
  • Macrophage Activation Syndrome / diagnosis
  • Macrophage Activation Syndrome / etiology*
  • Macrophage Activation Syndrome / mortality
  • Macrophage Activation Syndrome / therapy
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / diagnosis
  • Prognosis