• Madeeha Gulzar postgraduate trainee,General Medicine,SIHS,lhr
  • Ali Sabir postgraduate trainee,General Medicine,SIHS,lhr
  • Muhammad Afzal Hamdani MBBS,DIP CARD, MRCP,FCPS(Medicine), FCPS ( Rheumatology), Assistant Professor Medicine, SIHS
  • Asma Saadia MBBS,FCPS (Pathology), Assistant Professor Pathology, SIHS


Macrophage activation syndrome (MAS) is a potentially lethal complication of chronic rheumatological conditions like ankylosing spondylitis, rheumatoid arthritis, and adult-onset Still’s disease (AOSD). It is a multisystem inflammatory syndrome caused by immense cytokine release from activated lymphocytes and macrophages. We give an account of the incidence of a twenty years old Asian girl suffering from non-remitting fever and an evanescent rash for last ten weeks. Physical examination and laboratory work-up suggested high grade fever, pancytopenia, hyperferritinemia, hypertriglyceridemia, hypofibrinogenemia and impaired liver function. Bone marrow biopsy was also done. It showed active hemophagocytosis. She was diagnosed as a case of Macrophage Activation Syndrome associated with Adult Onset Still’s disease. She was treated with high dose steroids and cyclosporine and recovered completely.Keywords: Adult Onset Still’s disease, Macrophage Activation Syndrome, hemophagocytosis, Bone Marrow Biopsy

Author Biographies

Madeeha Gulzar, postgraduate trainee,General Medicine,SIHS,lhr

post graduate trainee,General Medicine,Lhr

Ali Sabir, postgraduate trainee,General Medicine,SIHS,lhr

postgraduate trainee,General Medicine,SIHS,lhr

Muhammad Afzal Hamdani, MBBS,DIP CARD, MRCP,FCPS(Medicine), FCPS ( Rheumatology), Assistant Professor Medicine, SIHS

MBBS,DIP CARD, MRCP,FCPS(Medicine), FCPS ( Rheumatology)        Assistant Professor Medicine, SIHS

Asma Saadia, MBBS,FCPS (Pathology), Assistant Professor Pathology, SIHS

MBBS,FCPS (Pathology),        Assistant Professor Pathology, SIHS 


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