engleski

A Case Report Macrophage activating syndrome

Macrophage-activating syndrome (MAS) is a severe complication of several chronic rheumatic diseases, the most common being systemic-onset juvenile idiopathic arthritis. This is the case of a patient, age 25, who presented with a majority of MAS symptoms. He was not previously diagnosed with any chronic rheumatoid diseases, although suffering occasional arthralgia of unknown origin in childhood. The patient was admitted to hospital due to acute febrile disease that started with cellulitis and lymphadenitis of the right side of the neck, which regressed three days after administration of antimicrobial therapy. However, the patient was still febrile with progression of red, rough, non itchy macular rash which spread over most of his body. He also developed mild edema, redness and pain in both testicles accompanied by pain and edema of both TC joints. After 4 days of admittance the patient developed dyspnea and cough. Diffuse pneumonitis with pleural reaction was seen on chest X-ray which later progressed to pleural effusion. Signs of myopericarditis were verified by ultrasound and Furosemid with potassium preparation were administered. Malignant, autoimmune and infectious diseases were ruled out based on the laboratory results. Due to development of many immunologic manifestations he was also given corticosteroid therapy which resulted in diminished fever, regression of orchitis, arthritis and gradual withdrawal of skin rash, pleural infusion and signs of myocarditis. Although the patient was never previously diagnosed with rheumatic disease, based upon the clinical course of the disease in conjunction with laboratory test results we can conclude that this was most likely a case of MAS.

Macrophage-activating syndrome (MAS); Chronic rheumatic disease

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