A Study of Soluble CD 163 as a Predictor of Macrophage Activation Syndrome in Patients with Systemic Onset Juvenile Idiopathic Arthritis

Abstract

JIA is the most common chronic arthropathy in pediatrics. SJIA represents 10-15% of all JIA subtypes with the highest mortality rate (about two-thirds of all mortalities in cases of JIA) and it was recently distinguished as a separate category being multifactorial auto-inflammatory rather than autoimmune disease. MAS represents the major percentage of the mortality observed in SJIA. It is overt in 10% of children with SJIA with prevalence of subclinical MAS in another 30–40% of patients. The problem with MAS is mainly confined to the delayed diagnosis and, hence, the delayed start of proper management. The aim of this work was to study the value of the soluble monocyte/macrophage lineage cell marker CD163 through monitoring its levels, over a one year period, together with soluble CD25 versus other clinical and laboratory criteria of MAS. This study was conducted over a one year period of follow up of SJIA patients comparing their serum levels of sCD163, sCD25 and other laboratory markers of MAS with a group of patients with MAS and HLH and another group of healthy age matched children as controls.