Case Report
Volume: 6 | Issue: 2 | Published: Feb 28, 2022 | Pages: 27 - 32 | DOI: 10.24911/ejmcr/173-1608028385
Macrophage activation syndrome in a young adult patient with a background of systemic lupus erythematosus: a case report
Authors: Chi Chun Wan , Teresa Doherty
Article Info
Authors
Chi Chun Wan
Barking Havering Redbridge University Trust, United Kingdom
Teresa Doherty
Barking Havering Redbridge University Trust, Untied Kingdom.
Publication History
Received: December 15, 2020
Accepted: November 22, 2021
Published: February 28, 2022
Abstract
Background: Macrophage activation syndrome (MAS) is a rare but potentially life-threatening condition associated with systemic lupus erythematosus (SLE), as well as several other autoimmune conditions. Case Presentation: We present a case of MAS in a 30-year-old patient with a background of SLE presenting with persistent fever and hemodynamic instability. Broad-spectrum antibiotics were initially started for possible sepsis of unknown origin, but a lack of response or evidence of an infection source led to further laboratory investigations and additional diagnostic imaging. Hyperferritinemia, a low fibrinogen, hypertriglyceridemia, and pancytopenia raised the suspicion of MAS. Echocardiography revealed a pericardial effusion requiring pericardiocentesis. With rapid disease progression, multiorgan failure ensued, and shortly after a high dose, methylprednisolone was commenced; the patient's condition worsened and she died after a cardiac arrest. Conclusion: This case highlights the challenges involved in diagnosing MAS and in differentiating it from more common presentations such as sepsis or autoimmune disease flares, and demonstrates the possible rapid disease progression. Therefore, early recognition of certain clinical features and laboratory markers are essential to enable early diagnosis, commencement of immunosuppressive treatment, and to ultimately improve outcomes in such critically unwell patients.
Keywords: Macrophage Activation Syndrome, Systemic Lupus Erythematosus, Rare Rheumatology Diseases, Diagnosis, Ferritin, Mortality, Abstract, green
Pubmed Style
Chi Chun Wan, Teresa Doherty. Macrophage activation syndrome in a young adult patient with a background of systemic lupus erythematosus: a case report. EJMCR. 2022; 28 (February 2022): 27-32. doi:10.24911/ejmcr/173-1608028385
Web Style
Chi Chun Wan, Teresa Doherty. Macrophage activation syndrome in a young adult patient with a background of systemic lupus erythematosus: a case report. https://ejmcr.com/articles/1280 [Access: December 25, 2024]. doi:10.24911/ejmcr/173-1608028385
AMA (American Medical Association) Style
Chi Chun Wan, Teresa Doherty. Macrophage activation syndrome in a young adult patient with a background of systemic lupus erythematosus: a case report. EJMCR. 2022; 28 (February 2022): 27-32. doi:10.24911/ejmcr/173-1608028385
Vancouver/ICMJE Style
Chi Chun Wan, Teresa Doherty. Macrophage activation syndrome in a young adult patient with a background of systemic lupus erythematosus: a case report. EJMCR. (2022), [cited December 25, 2024]; 28 (February 2022): 27-32. doi:10.24911/ejmcr/173-1608028385
Harvard Style
Chi Chun Wan, Teresa Doherty (2022) Macrophage activation syndrome in a young adult patient with a background of systemic lupus erythematosus: a case report. EJMCR, 28 (February 2022): 27-32. doi:10.24911/ejmcr/173-1608028385
Chicago Style
Chi Chun Wan, Teresa Doherty. "Macrophage activation syndrome in a young adult patient with a background of systemic lupus erythematosus: a case report." 28 (2022), 27-32. doi:10.24911/ejmcr/173-1608028385
MLA (The Modern Language Association) Style
Chi Chun Wan, Teresa Doherty. "Macrophage activation syndrome in a young adult patient with a background of systemic lupus erythematosus: a case report." 28.February 2022 (2022), 27-32. Print. doi:10.24911/ejmcr/173-1608028385
APA (American Psychological Association) Style
Chi Chun Wan, Teresa Doherty (2022) Macrophage activation syndrome in a young adult patient with a background of systemic lupus erythematosus: a case report. , 28 (February 2022), 27-32. doi:10.24911/ejmcr/173-1608028385