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Methotrexate as a possible trigger of macrophage activation syndrome in systemic juvenile idiopathic arthritis
A Ravelli1, M C Caria, S Buratti
1Dipartimento di Scienze Pediatriche, Università di Pavia, Istituto di Ricovero e Cura a Carattere Scientifico S. Matteo, Italy.
Abstract:
Macrophage activation syndrome (MAS) is a potentially life threatening complication of chronic rheumatic diseases, particularly systemic juvenile idiopathic arthritis (JIA). A number of triggers have been related to the development of MAS, including viral infections, nonsteroidal antiinflammatory drug therapy, and gold salt injections. We describe a patient with systemic JIA who developed MAS shortly after receiving methotrexate, suggesting that this drug can be regarded as a potential trigger of MAS in children with JIA.
Insights
Macrophage activation syndrome (MAS), a serious complication of systemic juvenile idiopathic arthritis (JIA), can be triggered by medications. This case suggests methotrexate may be a potential trigger for MAS in children with JIA.
Area of Science:
- Rheumatology
- Pediatrics
- Immunology
Background:
- Macrophage activation syndrome (MAS) is a severe, life-threatening condition associated with chronic rheumatic diseases.
- Systemic juvenile idiopathic arthritis (JIA) is a primary rheumatic condition linked to MAS development.
- Known MAS triggers include infections, NSAIDs, and gold salts.
Observation:
- A case study involving a patient diagnosed with systemic JIA is presented.
- The patient developed MAS shortly after initiating methotrexate therapy.
- This temporal association suggests a potential link between methotrexate and MAS onset.
Findings:
- Methotrexate, a common treatment for JIA, is identified as a potential trigger for MAS.
- This finding expands the known etiological factors for MAS in pediatric rheumatic diseases.
- The study highlights the importance of considering drug-induced MAS in JIA patients.
Implications:
- Clinicians should be vigilant for MAS in systemic JIA patients treated with methotrexate.
- Further research is warranted to confirm methotrexate as a MAS trigger in JIA.
- This case contributes to understanding and managing MAS in pediatric rheumatology.