Cert Rheumatology(SA) Paed Practice Questions - Sub-specialty Certificate In Paediatric Rheumatology Of The College Of Paediatricians Of South Africa Exam

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A 7-year-old boy with known systemic JIA on oral prednisolone develops non-remitting high fevers, lethargy, purpura, and confusion. Laboratory results show a sudden drop in ESR from 90 mm/hr to 12 mm/hr, while CRP remains elevated at 110 mg/L. Hemoglobin drops from 11.2 to 7.8 g/dL, platelets drop from 520 x 10^9/L to 45 x 10^9/L, fibrinogen is decreased at 1.1 g/L (normal 2.0-4.0), and serum ferritin rises to 28,500 µg/L. What life-threatening sJIA complication has developed?

Infective endocarditis Severe sJIA disease flare without complication Methotrexate-induced bone marrow suppression Macrophage Activation Syndrome (MAS)

Correct Answer:

Macrophage Activation Syndrome (MAS)

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