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Interleukin-18 for predicting the development of macrophage activation syndrome in systemic juvenile idiopathic arthritis

2015; Elsevier BV; Volume: 160; Issue: 2 Linguagem: Inglês

10.1016/j.clim.2015.06.005

1521-7035

Masaki Shimizu, Yasuo Nakagishi, Natsumi Inoue, Mao Mizuta, Giyo Ko, Yutaka Saikawa, Tomohiro Kubota, Yuichi Yamasaki, Syuji Takei, Akihiro Yachie,

Kawasaki Disease and Coronary Complications

To assess the role of IL-6/IL-18 in the pathogenesis of systemic juvenile idiopathic arthritis (s-JIA) and to investigate the clinical significance of serum IL-18 levels for predicting macrophage activation syndrome (MAS) development, we measured the serum IL-6/IL-18 levels in 76s-JIA patients, including 15 with MAS, and compared them with the clinical features. We identified 2 distinct subsets on the basis of serum IL-6/IL-18 levels. The IL-18-dominant subset had more patients who developed MAS. Serum IL-18 levels during active phase in patients with MAS were significantly higher than those without MAS. The cutoff value of serum IL-18 levels for predicting MAS development was 47750 pg/ml. The patients with IL-18 dominant subset at their disease onset were significantly more likely to develop MAS after TCZ therapy started. IL-18 might have a key role in the pathogenesis of MAS. Serum IL-18 levels >47750 pg/ml might be useful to predict MAS development.