Prahalad S, Bove K E, Dickens D, Lovell D J, Grom A A
Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Ohio 45229-3039, USA.
J Rheumatol. 2001 Sep;28(9):2120-4.
Macrophage activation syndrome (MAS), a recognized complication of systemic juvenile rheumatoid arthritis (sJRA), has been associated with significant morbidity and mortality. Dysregulation of macrophage-lymphocyte interactions leading to uncontrolled proliferation of highly activated macrophages and massive release of proinflammatory cytokines including tumor necrosis factor-alpha (TNF-alpha) appears to be central to the pathogenesis of this syndrome. Until now the mainstay of therapy has been corticosteroids and cyclosporin A. We describe a patient with MAS and sJRA successfully treated with the anti-TNF agent etanercept. The outcome in this patient suggests etanercept might be an effective therapeutic agent in MAS.
巨噬细胞活化综合征（MAS）是系统性幼年类风湿性关节炎（sJRA）一种公认的并发症，与显著的发病率和死亡率相关。巨噬细胞与淋巴细胞相互作用失调，导致高度活化的巨噬细胞不受控制地增殖，并大量释放包括肿瘤坏死因子-α（TNF-α）在内的促炎细胞因子，这似乎是该综合征发病机制的核心。到目前为止，治疗的主要手段一直是使用皮质类固醇和环孢素A。我们描述了一名患有MAS和sJRA的患者，使用抗TNF药物依那西普成功治愈。该患者的治疗结果表明依那西普可能是治疗MAS的一种有效药物。
