Performance of Current Guidelines for Diagnosis of Macrophage Activation Syndrome Complicating Systemic Juvenile Idiopathic Arthritis

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art_DAVI_Performance_of_Current_Guidelines_for_Diagnosis_of_Macrophage_2014.PDF (94.13 KB)
Citações na Scopus
91
Tipo de produção
article
Data de publicação
2014
Editora
WILEY-BLACKWELL
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
DAVI, Sergio
MINOIA, Francesca
PISTORIO, Angela
HORNE, AnnaCarin
CONSOLARO, Alessandro
ROSINA, Silvia
BOVIS, Francesca
CIMAZ, Rolando
GAMIR, Maria Luz
ILOWITE, Norman T.
Autor de Grupo de pesquisa
Paediat Rheumatology Int Trials Or
Childhood Arthritis Rheumatology R
Pediat Rheumatology Collaborative
Histiocyte Soc
Editores
Coordenadores
Organizadores
Citação
ARTHRITIS & RHEUMATOLOGY, v.66, n.10, p.2871-2880, 2014
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
ObjectiveTo compare the capacity of the 2004 diagnostic guidelines for hemophagocytic lymphohistiocytosis (HLH-2004) with the capacity of the preliminary diagnostic guidelines for systemic juvenile idiopathic arthritis (JIA)-associated macrophage activation syndrome (MAS) to discriminate MAS complicating systemic JIA from 2 potentially confusable conditions, represented by active systemic JIA without MAS and systemic infection. MethodsInternational pediatric rheumatologists and hemato-oncologists were asked to retrospectively collect clinical information from patients with systemic JIA-associated MAS and confusable conditions. The ability of the guidelines to differentiate MAS from the control diseases was evaluated by calculating the sensitivity and specificity of each set of guidelines and the kappa statistics for concordance with the physician's diagnosis. Owing to the fact that not all patients were assessed for hemophagocytosis on bone marrow aspirates and given the lack of data on natural killer cell activity and soluble CD25 levels, the HLH-2004 guidelines were adapted to enable the diagnosis of MAS when 3 of 5 of the remaining items (3/5-adapted) or 4 of 5 of the remaining items (4/5-adapted) were present. ResultsThe study sample included 362 patients with systemic JIA and MAS, 404 patients with active systemic JIA without MAS, and 345 patients with systemic infection. The best capacity to differentiate MAS from systemic JIA without MAS was found when the preliminary MAS guidelines were applied. The 3/5-adapted HLH-2004 guidelines performed better than the 4/5-adapted guidelines in distinguishing MAS from active systemic JIA without MAS. The 3/5-adapted HLH-2004 guidelines and the preliminary MAS guidelines with the addition of ferritin levels 500 ng/ml discriminated best between MAS and systemic infections. ConclusionThe preliminary MAS guidelines showed the strongest ability to identify MAS in systemic JIA. The addition of hyperferritinemia enhanced their capacity to differentiate MAS from systemic infections. The HLH-2004 guidelines are likely not appropriate for identification of MAS in children with systemic JIA.
Palavras-chave
URI
https://observatorio.fm.usp.br/handle/OPI/9034
Referências
  1. Arico M, 1996, LEUKEMIA, V10, P197
  2. Athreya BH, 2002, CLIN EXP RHEUMATOL, V20, P121
  3. Behrens EM, 2011, J CLIN INVEST, V121, P2264, DOI [10.1172/JCI43157, 10.1172/JC143157]
  4. Behrens EM, 2007, J RHEUMATOL, V34, P1133
  5. Bleesing J, 2007, ARTHRITIS RHEUM, V56, P965, DOI 10.1002/art.22416
  6. Bode SFN, 2012, ARTHRITIS RES THER, V14, DOI 10.1186/ar3843
  7. Cascio A, 2012, EUR REV MED PHARMACO, V16, P1324
  8. COHEN J, 1960, EDUC PSYCHOL MEAS, V20, P37, DOI 10.1177/001316446002000104
  9. Davi S, 2012, ANN PAEDIAT RHEUMATO, V1, P1
  10. Davi S, 2011, J RHEUMATOL, V38, P764, DOI 10.3899/jrheum.100996
  11. Glas AS, 2003, J CLIN EPIDEMIOL, V56, P1129, DOI 10.1016/S0895-4356(03)00177-X
  12. Gorelik M, 2013, J RHEUMATOL, V40, P1191, DOI 10.3899/jrheum.121131
  13. Grom AA, 2010, CURR OPIN RHEUMATOL, V22, P561, DOI 10.1097/01.bor.0000381996.69261.71
  14. Henter JI, 2007, PEDIATR BLOOD CANCER, V48, P124, DOI 10.1002/pbc.21039
  15. Ho C, 2014, AM J CLIN PATHOL, V141, P62, DOI 10.1309/AJCPMD5TJEFOOVBW
  16. Kelly A, 2007, CURR OPIN RHEUMATOL, V19, P477, DOI 10.1097/BOR.0b013e32825a6a79
  17. LANDIS JR, 1977, BIOMETRICS, V33, P363, DOI 10.2307/2529786
  18. Lehmberg K, 2013, J PEDIATR-US, V162, P1245, DOI 10.1016/j.jpeds.2012.11.081
  19. PELKONEN P, 1986, ACTA PAEDIATR SCAND, V75, P64, DOI 10.1111/j.1651-2227.1986.tb10158.x
  20. Petty RE, 2004, J RHEUMATOL, V31, P390
  21. Ramanan AV, 2003, J RHEUMATOL, V30, P2513
  22. Ravelli A, 2012, GENES IMMUN, V13, P289, DOI 10.1038/gene.2012.3
  23. Ravelli A, 2005, J PEDIATR, V146, P598, DOI 10.1016/j.jpeds.2004.12.016
  24. Ravelli A, 2008, HANDB SYST AUTOIMMUN, V6, P55, DOI 10.1016/S1571-5078(07)06008-4
  25. Ravelli A, 2002, CURR OPIN RHEUMATOL, V14, P548, DOI 10.1097/01.BOR.0000020666.29529.57
  26. Reddy VV, 2014, INT J RHEUM DIS, V17, P261, DOI 10.1111/1756-185X.12196
  27. Sawhney S, 2001, ARCH DIS CHILD, V85, P421, DOI 10.1136/adc.85.5.421
  28. Stephan JL, 2001, RHEUMATOLOGY, V40, P1285, DOI 10.1093/rheumatology/40.11.1285

Coleções
Artigos e Materiais de Revistas Científicas - FM/MPE
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - LIM/36