PT  - JOURNAL ARTICLE
AU  - Angelo Ravelli
AU  - Francesca Minoia
AU  - Sergio Davì
AU  - AnnaCarin Horne
AU  - Francesca Bovis
AU  - Angela Pistorio
AU  - Maurizio Aricò
AU  - Tadej Avcin
AU  - Edward M Behrens
AU  - Fabrizio De Benedetti
AU  - Alexandra Filipovic
AU  - Alexei A Grom
AU  - Jan-Inge Henter
AU  - Norman T Ilowite
AU  - Michael B Jordan
AU  - Raju Khubchandani
AU  - Toshiyuki Kitoh
AU  - Kai Lehmberg
AU  - Daniel J Lovell
AU  - Paivi Miettunen
AU  - Kim E Nichols
AU  - Seza Ozen
AU  - Jana Pachlopnik Schmid
AU  - Athimalaipet V Ramanan
AU  - Ricardo Russo
AU  - Rayfel Schneider
AU  - Gary Sterba
AU  - Yosef Uziel
AU  - Carol Wallace
AU  - Carine Wouters
AU  - Nico Wulffraat
AU  - Erkan Demirkaya
AU  - Hermine I Brunner
AU  - Alberto Martini
AU  - Nicolino Ruperto
AU  - Randy Q Cron
TI  - Expert consensus on dynamics of laboratory tests for diagnosis of macrophage activation syndrome complicating systemic juvenile idiopathic arthritis
AID  - 10.1136/rmdopen-2015-000161
DP  - 2016 Jan 01
TA  - RMD Open
PG  - e000161
VI  - 2
IP  - 1
4099  - http://rmdopen.bmj.com/content/2/1/e000161.short
4100  - http://rmdopen.bmj.com/content/2/1/e000161.full
SO  - RMD Open2016 Jan 01; 2
AB  - Objective To identify which laboratory tests that change over time are most valuable for the timely diagnosis of macrophage activation syndrome (MAS) complicating systemic juvenile idiopathic arthritis (sJIA).Methods A multistep process, based on a combination of expert consensus and analysis of real patient data, was conducted. A panel of experts was first asked to evaluate 115 profiles of patients with MAS, which included the values of laboratory tests at the pre-MAS visit and at MAS onset, and the change in values between the two time points. The experts were asked to choose the 5 laboratory tests in which change was most important for the diagnosis of MAS and to rank the 5 selected tests in order of importance. The relevance of change in laboratory parameters was further discussed and ranked by the same experts at a consensus conference.Results Platelet count was the most frequently selected test, followed by ferritin level, aspartate aminotransferase (AST), white cell count, neutrophil count, and fibrinogen and erythrocyte sedimentation rate. Ferritin was most frequently assigned the highest score. At the end of the process, platelet count, ferritin level and AST were the laboratory tests in which the experts found change over time to be most important.Conclusions We identified the laboratory tests in which change over time is most valuable for the early diagnosis of MAS in sJIA. The dynamics of laboratory values during the course of MAS should be further scrutinised in a prospective study in order to establish the optimal cut-off values for their variation.