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Abstract Number: 370

Validation of 2016 ACR/EULAR Classification Criteria of Macrophage Activation Syndrome Complicating Systemic Juvenile Idiopathic Arthritis in Japanese Patients

Masaki Shimizu1, Mao Mizuta1, Takahiro Yasumi2, Naomi Iwata3, Yuka Okura4, Noriko Kinjo5, Hiroaki Umebayashi6, Tomohiro Kubota7, Yasuo Nakagishi8, Kenichi Nishimura9, Masato Yashiro10, Junko Yasumura11, Kazuko Yamazaki12, Hiroyuki Wakiguchi13, Nami Okamoto14 and Masaaki Mori15, 1Department of Pediatrics, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan, 2Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan, 3Department of Immunology and Infectious Diseases, Aichi Children’s Health and Medical Center, Obu, Japan, 4Department of Pediatrics, KKR Sapporo Medical Center, Sapporo, Japan, 5Department of Pediatrics, Faculty of medicine, University of the Ryukyus, Nakagami-gun, Japan, 6Department of Rheumatics, Miyagi Children’s Hospital, Sendai, Japan, 7Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan, Kagoshima, Japan, 8Department of Pediatric Rheumatology, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Japan, 9Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan, 10Department of Pediatrics, Okayama University Hospital, Okayama, Japan, 11Department of Pediatrics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan, 12Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan, 13Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan, 14Department of Pediatrics, Osaka Medical College, Takatsuki, Japan, 15Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: classification criteria and macrophage activation syndrome, Systemic JIA

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Session Information

Date: Sunday, November 5, 2017

Title: Pediatric Rheumatology – Clinical and Therapeutic Aspects Poster I: Autoinflammatory Disorders and Miscellaneous

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: To validate the 2016 ACR/EULAR classification criteria of macrophage activation syndrome (MAS) complicating systemic juvenile idiopathic arthritis (s-JIA) in Japanese patients.

Methods: A combination of expert consensus and analysis of real patient data was conducted by a panel of 15 paediatric rheumatologists. Eighty-three profiles comprised 25 patients with s-JIA–associated MAS and 58 patients with active s-JIA without evidence of MAS. From these profiles, 19 points for full-blown MAS, 16 points for MAS onset and 58 points for acute s-JIA without MAS were evaluated.

Results:  Evaluation of the classification criteria to discriminate full-blown MAS from acute s-JIA without MAS showed a sensitivity of 0.947 and specificity of 1.000 at the time of full-blown MAS. Sensitivity was 0.438 and specificity 1.000 at the time of MAS onset. The number of measurement items that fulfilled the criteria increased in full-blown MAS compared to that at MAS onset. At MAS onset, the positive rates of patients who met the criteria for platelet counts and triglycerides were low, whereas those for aspartate aminotransferase and fibrinogen were relatively high. At full-blown MAS, the number of patients who met the criteria for each measurement item increased.

Conclusion:  The classification criteria for MAS complicating s-JIA had a very high diagnostic performance. However, the diagnostic sensitivity for MAS onset was relatively low. For the early diagnosis of MAS in s-JIA, the dynamics of laboratory values during the course of MAS should be further investigated.


Disclosure: M. Shimizu, None; M. Mizuta, None; T. Yasumi, None; N. Iwata, None; Y. Okura, None; N. Kinjo, None; H. Umebayashi, None; T. Kubota, None; Y. Nakagishi, None; K. Nishimura, None; M. Yashiro, None; J. Yasumura, None; K. Yamazaki, None; H. Wakiguchi, None; N. Okamoto, None; M. Mori, None.

To cite this abstract in AMA style:

Shimizu M, Mizuta M, Yasumi T, Iwata N, Okura Y, Kinjo N, Umebayashi H, Kubota T, Nakagishi Y, Nishimura K, Yashiro M, Yasumura J, Yamazaki K, Wakiguchi H, Okamoto N, Mori M. Validation of 2016 ACR/EULAR Classification Criteria of Macrophage Activation Syndrome Complicating Systemic Juvenile Idiopathic Arthritis in Japanese Patients [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/validation-of-2016-acreular-classification-criteria-of-macrophage-activation-syndrome-complicating-systemic-juvenile-idiopathic-arthritis-in-japanese-patients/. Accessed .
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