Publication date: Sep 13, 2025
Macrophage activation syndrome (MAS) is a potentially life-threatening complication requiring early diagnosis and prompt treatment in rheumatic diseases such as systemic juvenile idiopathic arthritis (sJIA). Recently, multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was reported to be complicated by MAS. The diagnostic criteria for MAS-associated MIS-C (MIS-C/MAS) remain unknown. We report the case of a 12-year-old boy who presented with fever for 4 days, swollen cervical lymph nodes, conjunctival congestion, red lips, strawberry tongue, irregular erythematous lesions, abdominal pain, and diarrhoea; he had coronavirus disease 2019 (COVID-19) 1 month prior. The patient was diagnosed MIS-C/MAS based on the criteria for sJIA/MAS, treated with intravenous immunoglobulin, glucocorticoids, and cyclosporine without any coronary artery sequelae. Evaluation of the patient’s serum cytokine profile revealed that CXCL9 level (14259 pg/mL, reference range
| Concepts | Keywords |
|---|---|
| Children | Cytokine profile |
| Coronavirus | immunosuppressive treatment |
| Old | macrophage activation syndrome |
| Serum | |
| Strawberry |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | Macrophage activation syndrome |
| disease | MESH | syndrome |
| disease | MESH | rheumatic diseases |
| disease | MESH | juvenile idiopathic arthritis |
| disease | MESH | multisystem inflammatory syndrome in children |
| disease | MESH | infection |
| disease | MESH | coronavirus disease 2019 |
| drug | DRUGBANK | Immune Globulin Human |
| drug | DRUGBANK | Ciclosporin |
| disease | MESH | sequelae |