title: Successful treatment of macrophage activation syndrome in a patient with dermatomyositis by combination with immunosuppressive therapy and plasmapheresis.
abstract: Macrophage activation syndrome (MAS), also known as secondary hemophagocytic lymphohistiocytosis, is mediated by cytokine overproduction from excessive activation of T lymphocytes and macrophages. We present a dermatomyositis patient with MAS, caused by hypercytokinemia. The combination of tacrolimus and plasma exchange therapy was effective in this case for treating MAS. This combination therapy is especially useful for MAS refractory to steroids.
authors.affiliation: a Department of Medicine , Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine , Kurume , Japan.
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Kaieda
authors.affiliation: a Department of Medicine , Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine , Kurume , Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Yoshida
authors.affiliation: a Department of Medicine , Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine , Kurume , Japan.
authors.forename: Fumiya
authors.initials: F
authors.lastname: Yamashita
authors.affiliation: a Department of Medicine , Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine , Kurume , Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Okamoto
authors.affiliation: a Department of Medicine , Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine , Kurume , Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ida
authors.affiliation: a Department of Medicine , Division of Respirology, Neurology and Rheumatology, Kurume University School of Medicine , Kurume , Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Hoshino
authors.affiliation: b Center for Rheumatic Diseases, Kurume University Medical Center , Kurume , Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Fukuda
mesh_terms: D003131:Combined Modality Therapy; D003882:Dermatomyositis / Q000150:complications*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D055501:Macrophage Activation Syndrome / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D016559:Tacrolimus / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus
keywords: Dermatomyositis; Hypercytokinemia; Macrophage activation syndrome; Plasma exchange; Tacrolimus