title: Dissecting the heterogeneity of macrophage activation syndrome complicating systemic juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To seek insights into the heterogeneity of macrophage activation syndrome (MAS) complicating systemic juvenile idiopathic arthritis (sJIA) through the analysis of a large patient sample collected in a multinational survey.
  
  
  METHODS
  International pediatric rheumatologists and hemato-oncologists entered their patient data, collected retrospectively, in a Web-based database. The demographic, clinical, laboratory, histopathologic, therapeutic, and outcome data were analyzed in relation to (1) geographic location of caring hospital, (2) subspecialty of attending physician, (3) demonstration of hemophagocytosis, and (4) severity of clinical course.
  
  
  RESULTS
  A total of 362 patients were included by 95 investigators from 33 countries. Demographic, clinical, laboratory, and histopathologic features were comparable among patients seen in diverse geographic areas or by different pediatric specialists. Patients seen in North America were given biologics more frequently. Patients entered by pediatric hemato-oncologists were treated more commonly with biologics and etoposide, whereas patients seen by pediatric rheumatologists more frequently received cyclosporine. Patients with demonstration of hemophagocytosis had shorter duration of sJIA at MAS onset, higher prevalence of hepatosplenomegaly, lower levels of platelets and fibrinogen, and were more frequently administered cyclosporine, intravenous immunoglobulin (IVIG), and etoposide. Patients with severe course were older, had longer duration of sJIA at MAS onset, had more full-blown clinical picture, and were more commonly given cyclosporine, IVIG, and etoposide.
  
  
  CONCLUSIONS
  The clinical spectrum of MAS is comparable across patients seen in different geographic settings or by diverse pediatric subspecialists. There was a disparity in the therapeutic choices among physicians that underscores the need to establish uniform therapeutic protocols.
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Francesca
authors: F
authors: Minoia
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Sergio
authors: S
authors: Davì
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: AnnaCarin
authors: A
authors: Horne
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Francesca
authors: F
authors: Bovis
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Erkan
authors: E
authors: Demirkaya
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Jonathan
authors: J
authors: Akikusa
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Nuray A
authors: NA
authors: Ayaz
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Sulaiman M
authors: SM
authors: Al-Mayouf
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Patrizia
authors: P
authors: Barone
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Bianca
authors: B
authors: Bica
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Isabel
authors: I
authors: Bolt
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Luciana
authors: L
authors: Breda
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Carmen
authors: C
authors: De Cunto
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Sandra
authors: S
authors: Enciso
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Romina
authors: R
authors: Gallizzi
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Thomas
authors: T
authors: Griffin
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Teresa
authors: T
authors: Hennon
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Gerd
authors: G
authors: Horneff
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Michael
authors: M
authors: Jeng
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Ageza M
authors: AM
authors: Kapovic
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Jeffrey M
authors: JM
authors: Lipton
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Silvia
authors: S
authors: Magni Manzoni
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Ingrida
authors: I
authors: Rumba-Rozenfelde
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Claudia Saad
authors: CS
authors: Magalhaes
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Wafaa M
authors: WM
authors: Sewairi
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Kimo C
authors: KC
authors: Stine
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Olga
authors: O
authors: Vougiouka
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Lehn K
authors: LK
authors: Weaver
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Zane
authors: Z
authors: Davidsone
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Jaime
authors: J
authors: De Inocencio
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Maka
authors: M
authors: Ioseliani
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Bianca
authors: B
authors: Lattanzi
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Hasan
authors: H
authors: Tezer
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Antonella
authors: A
authors: Buoncompagni
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Paolo
authors: P
authors: Picco
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Nicolino
authors: N
authors: Ruperto
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Alberto
authors: A
authors: Martini
authors: From the Istituto Giannina Gaslini, Genoa, Italy; Karolinska University Hospital Solna, Stockholm, Sweden; Gulhane Military Medical Faculty, Ankara, Turkey; Royal Children's Hospital, Melbourne, Australia; Bakırkoy Maternity and Children Education and Research Hospital, Istanbul, Turkey; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Policlinico Università di Catania, Catania, Italy; Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil; Universitaetsklinik fuer Kinderheilkunde, Inselspital, Berne, Switzerland; Ospedale Policlinico, Chieti, Italy; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico; University of Messina, Messina, Italy; Carolinas HealthCare System, Charlotte, North Carolina; Women and Children's Hospital, Buffalo, New York, USA; Zentrum fuer Allgemeine Paediatrie und Neonatologie, Sankt Augustin, Germany; Stanford School of Medicine, Palo Alto, California, USA; Department for Immunology and Rheumatology, Children's Hospital of Zagreb, Zagreb, Croatia; Steven and Alexandra Cohen Children's Hospital of New York, New York, New York, USA; IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; University of Latvia, Riga, Latvia; Hospital das Clínicas, Botucatu, Brazil; King Fahad National Guard Hospital, Riyadh, Saudi Arabia; Arkansas Children's Hospital, Little Rock, Arkansas, USA; Kyriakou Children's Hospital of Athens, Athens, Greece; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Children's University Hospital, Riga, Latvia; Hospital Universitario 12 de Octubre, Madrid, Spain; M. Iashvili Children's Central Clinic, Tbilisi, Georgia; Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy; Gazi University, Ankara, Turkey; Università degli Studi di Genova, Genoa, Italy; University of Alabama at Birmingham, Birmingham, Alabama, USA.F. Minoia, MD; S. Davì, MD, Istituto Giannina Gaslini; A. Horne, M
authors: Randy Q
authors: RQ
authors: Cron
authors: Angelo
authors: A
authors: Ravelli
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D038622:Internationality; D055501:Macrophage Activation Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis
keywords: HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS; HEMOPHAGOCYTIC SYNDROMES; MACROPHAGE ACTIVATION SYNDROME; SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS