title: FDG-PET in macrophage activation syndrome associated with systemic juvenile idiopathic arthritis.
abstract: We herein describe a case of systemic juvenile idiopathic arthritis (s-JIA)-associated macrophage activation syndrome (MAS) in which the18Ffluorodeoxyglucose positron emission tomography (18FFDG-PET) findings were characteristic. The pattern of greater18FFDG accumulation into the spleen compared with the liver was more remarkable in this patient compared with s-JIA. This pattern, however, was also observed in cases of acute leukemia. In the present patient, serum interleukin (IL)-18 was extremely elevated (255 000 pg/mL), whereas in leukemia patients it is mildly elevated (360-1480 pg/mL).18FFDG-PET might be a useful indicator of s-JIA and MAS in patients with fever of unknown origin. The pattern of18FFDG accumulation, however, can also be observed in acute leukemia. The combination of18FFDG-PET and serum IL-18 might be useful for the diagnosis of s-JIA and MAS.
authors.affiliation: Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ikawa
authors.affiliation: Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: Mao
authors.initials: M
authors.lastname: Mizuta
authors.affiliation: Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Takakura
authors.affiliation: Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: Natsumi
authors.initials: N
authors.lastname: Inoue
authors.affiliation: Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: Ryosei
authors.initials: R
authors.lastname: Nishimura
authors.affiliation: Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yachie
mesh_terms: D001171:Arthritis, Juvenile / Q000150:complications / Q000000981:diagnostic imaging*; D002675:Child, Preschool; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D055501:Macrophage Activation Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: fluorodeoxyglucose positron emission tomography; interleukin-18; macrophage activation syndrome; systemic juvenile idiopathic arthritis