Rossano Martina, Rogani Greta, D'Errico Maria Maddalena, Cucchetti Martina, Baldo Francesco, Torreggiani Sofia, Beretta Gisella, Lanni Stefano, Petaccia Antonella, Agostoni Carlo, Filocamo Giovanni, Minoia Francesca
Pediatric Rheumatology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano IT and University of Milan, 20122 Milan, Italy.
Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy.
Children (Basel). 2022 Apr 15;9(4):564. doi: 10.3390/children9040564.
An association between infectious diseases and macrophage activation syndrome (MAS) has been reported, yet the exact role of infection in MAS development is still unclear. Here, a retrospective analysis of the clinical records of patients with rheumatic diseases complicated with MAS who were treated in a pediatric tertiary care center between 2011 and 2020 was performed. Any infection documented within the 30 days preceding the onset of MAS was reported. Out of 125 children in follow-up for systemic rheumatic diseases, 12 developed MAS, with a total of 14 episodes. One patient experienced three episodes of MAS. Clinical and/or laboratory evidence of infection preceded the onset of MAS in 12 events. Clinical features, therapeutic strategies, and patient outcomes were described. The aim of this study was to evaluate the possible role of infection as a relevant trigger for MAS development in children with rheumatic conditions. The pathogenetic pathways involved in the cross-talk between uncontrolled inflammatory activity and the immune response to infection deserve further investigation.
已有报道称感染性疾病与巨噬细胞活化综合征（MAS）之间存在关联，但感染在MAS发生过程中的确切作用仍不清楚。在此，对2011年至2020年期间在一家儿科三级护理中心接受治疗的合并MAS的风湿性疾病患者的临床记录进行了回顾性分析。报告了MAS发病前30天内记录的任何感染情况。在125名接受系统性风湿性疾病随访的儿童中，有12名发生了MAS，共14次发作。一名患者经历了3次MAS发作。在12次事件中，MAS发作前有临床和/或实验室感染证据。描述了临床特征、治疗策略和患者预后。本研究的目的是评估感染作为风湿性疾病患儿MAS发生相关触发因素的可能作用。不受控制的炎症活动与感染免疫反应之间相互作用的致病途径值得进一步研究。
