title: Dynamic Changes, Cut-Off Points, Sensitivity, and Specificity of Laboratory Data to Differentiate Macrophage Activation Syndrome from Active Disease.
abstract: OBJECTIVE
  To compare the laboratory data and changes in these data between patients with MAS and patients with flare-up of the autoimmune diseases.
  
  
  METHODS
  In a prospective study, the static laboratory data and dynamic changes in the selected data in 17 consecutive patients with MAS and 53 patients with active disease of SJIA, PJIA, Kawasaki disease, and SLE were compared. The ROC curve analysis was used to evaluate cut-off points, sensitivity, and specificity of the static and dynamic laboratory data to differentiate between MAS and active disease.
  
  
  RESULTS
  In the MAS group, the mean CRP3, ALT, AST, total bilirubin, ferritin, LDH, PT, PTT, and INR were significantly higher and the mean WBC2, PMN2, Lymph2, Hgb1, 2, 3, ESR2, serum albumin, and sodium were significantly lower than in control group. Some of the important cut-off points were PLT2 < 209000/microliter, AST > 38.5, ALT > 38, WBC < 8200 × 103/UL, ferritin > 5277 ng/mL.
  
  
  CONCLUSIONS
  The dynamic changes in some laboratory data, especially PLT, can differentiate between MAS and active disease. The changes in WBC, PMN, and ESR and the levels of the liver enzymes may also be helpful in the early differentiation. Very high levels of ferritin may also help the diagnosis along with other clinical and laboratory signs.
authors.affiliation: Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran.
authors.forename: Raheleh
authors.initials: R
authors.lastname: Assari
authors.affiliation: Pediatric Rheumatology Research Group, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran ; Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Vahid
authors.identifier: 0000-0003-4648-3573
authors.initials: V
authors.lastname: Ziaee
authors.affiliation: Farabi Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Mirmohammadsadeghi
authors.affiliation: Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran ; Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad-Hassan
authors.initials: MH
authors.lastname: Moradinejad
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001774:Blood Chemical Analysis / Q000592:standards; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008180:Lupus Erythematosus, Systemic / Q000097:blood*; D055501:Macrophage Activation Syndrome / Q000097:blood*; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood*; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers