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Macrophage Activation Syndrome (MAS)
Classified among the secondary or acquired forms of haemophagocytic lymphohistiocytosis (sHLH)

What?
A subset of
disease • Periodic fever ... multiorgan failure • Fever ... - Nonremitting fever ... #Diagnosis #Management ... #Hematology #Rheumatology
Causes of Fever of Unknown Origin (FUO) - Differential Diagnosis
 • Infection: Extrapulmonary tuberculosis, Abscess, Endocarditis,
Causes of Fever ... Lemierre's syndrome ... Brucellosis, Q fever ... Malignancy: - Hematologic ... . autoimmune): Lupus
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Features of Systemic Lupus ... (SLE) General: Fever ... Demyelinating syndromes ... valve lesions Abdominal ... symptoms #diagnosis #rheumatology
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
Demyelinating Syndrome ... autoantibodies that will cause ... CNS #neurology #rheumatology ... cerebritis #diagnosis #management ... #treatment
Purpura - Differential Diagnosis Framework

Non-blanchable, dark red to purple, hemorrhagic skin lesions that result from leakage
Kasabach-Merritt syndrome ... Gardner-Diamond syndrome ... mountain spotted fever ... Differential #Diagnosis #hematology ... #rheumatology #
Fever vs Hyperthermia
Fever:
 • Regulated in the hypothalamic thermoregulatory center
 • "Set point" raised by prostaglandin
Fever vs Hyperthermia ... Fever: • Regulated ... ; Serotonin syndrome ... BrighamChiefs #Fever ... comparison #diagnosis #management
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
• Rheumatic fever ... Antiphospholipid-antibody syndrome ... lesions • Discoid lupus ... Sarcoidosis #dermatology ... differential #diagnosis #rheumatology
Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
 • Epidemiology: 10-180/100,000, Typically Age 20-40, F:M
Systemic Lupus Erythematosus ... Diagnosis and Management ... Positive in 60-80% of cases ... life-threatening • Treatment ... #Summary #rheumatology
Kerion
Raised, boggy lesion with heaped up purulent nodules 
Caused by host's response to a fungal ringworm
purulent nodules Caused ... Hair loss • Fever ... Lymphadenopathy Treatment ... Griseofulvin #Kerion #Dermatology ... #Diagnosis #Management
Systemic Lupus Erythematosus - Summary
Antinuclear (ANA) - 95% - Initial screening test
Anti-dsDNA - 50%
 • Associated
Systemic Lupus Erythematosus ... severe disease Treatment ... #Systemic #Lupus ... Summary #diagnosis #rheumatology ... #management