Indian Journal of Rheumatology

ORIGINAL ARTICLE
Year
: 2022  |  Volume : 17  |  Issue : 2  |  Page : 118--123

Experience with macrophage activation syndrome associated with systemic lupus erythematosus: A single-center study from Pakistan


Saira Elaine Anwer Khan1, Roshila Shamim2, Asadullah Khan3, Shabnam Batool1, Muhammad Zeeshan Aslam2 
1 Department of Rheumatology, Shalimar Medical Complex, Lahore, Pakistan
2 Department of Rheumatology, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan
3 Department of Rheumatology, Bolan Medical College Quetta, Quetta, Pakistan

Correspondence Address:
Dr. Asadullah Khan
Department of Rheumatology, Bolan Medical College Quetta
Pakistan

Objective: The objective of the study was to evaluate the clinical, laboratory manifestations, and associations of macrophage activation syndrome (MAS) in a cohort of Pakistani patients with systemic lupus erythematous and to compare it with a well-characterized cohort of active systemic lupus erythematosus (SLE) without MAS. Materials and Methods: Patients with a diagnosis of SLE admitted from January 2017 to July 2019 were retrospectively reviewed. MAS ascertained by either clinical criteria or bone marrow biopsy were studied. Demographics, clinical, and laboratory parameters of MAS patients were evaluated and compared with a cohort of non-MAS active SLE. Results: A total of 305 patients of SLE were evaluated, out of these 18 patients had a diagnosis of MAS, making a MAS prevalence of 5.9%. Mean age of the patients was 27.25 ± 10.16 years. Female comprised 13 (72%) of MAS group. Fever was the most common clinical presentation (100%), followed by splenomegaly (38.9%) and lymphadenopathy (33.3%). At least 5 (27.8%0 patients had MAS as their initial manifestation. Anemia (88.9%), thrombocytopenia (88.9%), leukopenia (72%), and pancytopenia (55.6%) were prominent laboratory parameters. Mean serum ferritin of 1584 ng/ml and mean triglyceride of 270 mg/dl were reported. On comparing with non-MAS cohort; younger age, fever, lymphadenopathy, splenomegaly, mucocutaneous features, any type of cytopenia, high aspartate aminotransferase (AST), low albumin, and lactate dehydrogenase, all showed significant association with MAS (P < 0.05). Conclusion: Fever and associated cytopenias coupled with raised AST are strong predictors of MAS in patients with SLE.


How to cite this article:
Anwer Khan SE, Shamim R, Khan A, Batool S, Aslam MZ. Experience with macrophage activation syndrome associated with systemic lupus erythematosus: A single-center study from Pakistan.Indian J Rheumatol 2022;17:118-123


How to cite this URL:
Anwer Khan SE, Shamim R, Khan A, Batool S, Aslam MZ. Experience with macrophage activation syndrome associated with systemic lupus erythematosus: A single-center study from Pakistan. Indian J Rheumatol [serial online] 2022 [cited 2022 Jun 29 ];17:118-123
Available from: https://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2022;volume=17;issue=2;spage=118;epage=123;aulast=Anwer;type=0