RT Journal Article
SR Electronic
T1 Expert consensus on dynamics of laboratory tests for diagnosis of macrophage activation syndrome complicating systemic juvenile idiopathic arthritis
JF RMD Open
JO RMD Open
FD EULAR
SP e000161
DO 10.1136/rmdopen-2015-000161
VO 2
IS 1
A1 Angelo Ravelli
A1 Francesca Minoia
A1 Sergio Davì
A1 AnnaCarin Horne
A1 Francesca Bovis
A1 Angela Pistorio
A1 Maurizio Aricò
A1 Tadej Avcin
A1 Edward M Behrens
A1 Fabrizio De Benedetti
A1 Alexandra Filipovic
A1 Alexei A Grom
A1 Jan-Inge Henter
A1 Norman T Ilowite
A1 Michael B Jordan
A1 Raju Khubchandani
A1 Toshiyuki Kitoh
A1 Kai Lehmberg
A1 Daniel J Lovell
A1 Paivi Miettunen
A1 Kim E Nichols
A1 Seza Ozen
A1 Jana Pachlopnik Schmid
A1 Athimalaipet V Ramanan
A1 Ricardo Russo
A1 Rayfel Schneider
A1 Gary Sterba
A1 Yosef Uziel
A1 Carol Wallace
A1 Carine Wouters
A1 Nico Wulffraat
A1 Erkan Demirkaya
A1 Hermine I Brunner
A1 Alberto Martini
A1 Nicolino Ruperto
A1 Randy Q Cron
YR 2016
UL http://rmdopen.bmj.com/content/2/1/e000161.abstract
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.