| Macrophage activation syndrome: why and what should a gastroenterologist know. | |
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MedLine Citation:
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PMID: 20921900 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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We recently treated a patient with adult-onset Still's disease who developed macrophage activation syndrome (MAS) secondary to disseminated histoplasmosis while being treated with adalimumab. The gastroenterology service was consulted early, before diagnosis, as the patient presented with elevated liver enzymes and disseminated intravascular coagulation. MAS is an exaggerated immune response that can develop as a primary condition or secondary to infections, drugs and various diseases, resulting in liver dysfunction, encephalopathy, pancytopenia and disseminated intravascular coagulation. The development of MAS has also been reported in patients with inflammatory bowel disease and post-liver transplantation and has been triggered by medications used by gastroenterologists, particularly sulfasalazine and anti-tumor necrosis factor biologic modifiers. Therefore, we present a review on etiology, pathogenesis, clinical and laboratory features, and treatment of MAS with a focus on gastrointestinal aspects and presentations. MAS is a life threatening condition with a high mortality rate if untreated. Therefore it is important to recognize this condition early. As these patients may occasionally present to gastroenterologists we hope this review will increase awareness of this rare, but serious syndrome. |
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Authors:
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Bijal A Jayakar; Philip J Hashkes |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of clinical gastroenterology Volume: 45 ISSN: 1539-2031 ISO Abbreviation: J. Clin. Gastroenterol. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-02-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7910017 Medline TA: J Clin Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 210-4 Citation Subset: IM |
Affiliation:
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*Department of Rheumatic and Immunologic Diseases, Cleveland Clinic Foundation, Cleveland, OH †Pediatric Rheumatology Unit, Shaare Zedek Medical Center, Jerusalem, Israel. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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