Macrophage Activation Syndrome Upon Initiation of Adalimumab in a Patient With Longstanding Rheumatoid Arthritis

Macrophage activation syndrome (MAS) is a subset of hemophagocytic lymphohistiocytosis (HLH) described in patients with rheumatological disorders. Some triggers of MAS and HLH include infection, malignancy, rheumatological disease, HIV, and rarely medications such as immunosuppressants. In recent me...

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Bibliographic Details
Published inCurēus (Palo Alto, CA) Vol. 13; no. 1; p. e12825
Main Authors Chicos, Celestin, Zirkiyeva, Milana, Bandagi, Sabiha, Abrudescu, Adriana
Format Journal Article
LanguageEnglish
Published United States Cureus 20.01.2021
Subjects
Hematology
Internal Medicine
Rheumatology
macrophage activation syndrome
hemophagocytic lymphohistiocytosis
biologics
rheumatoid arthritis
adalimumab
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Summary:Macrophage activation syndrome (MAS) is a subset of hemophagocytic lymphohistiocytosis (HLH) described in patients with rheumatological disorders. Some triggers of MAS and HLH include infection, malignancy, rheumatological disease, HIV, and rarely medications such as immunosuppressants. In recent medical literature, biologic agents are increasingly recognized as a potential trigger, but the mechanism behind this remains poorly understood. We describe the case of a patient who developed MAS after initiating adalimumab and propose a potential pathophysiological link between biologics and this syndrome.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.12825