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Case report
Case of using mycophenolate in combination with steroids for concurrent macrophage activation syndrome and lupus flare
  1. Kavina Shah1,
  2. Andrew Porter1,
  3. Gagandeep Takhar1 and
  4. Venkat Reddy2
  1. 1Rheumatology Department, West Middlesex University Hospital NHS Trust, London, UK
  2. 2Centre for Rheumatology, University College London, London, UK
  1. Correspondence to Dr Kavina Shah; kavina.shah{at}


This report highlights the importance of tailored treatment strategies in severe systemic lupus erythematosus (SLE) flares driving the life-threatening condition, macrophage activation syndrome (MAS). We report the case of a 42-year-old woman with active systemic lupus erythematosus (SLE) who was diagnosed with MAS within 3 days of onset of lethargy, rash, joint pain and significant cytopenias. This early diagnosis meant that her condition was managed with less intensive immunosuppression with only modest doses of steroids and mycophenolate mofetil.

  • haematology (incl blood transfusion)
  • rheumatology
  • connective tissue disease
  • systemic lupus erythematosus

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  • Contributors KS: planned, designed and wrote the first draft of the report; also gained consent from the patient and requested the patient perspective. AP: acquired the case history, investigation details and carried out data interpretation. GT: involved in the discussion and overall care of the patient. VR: supervised this case report, reviewed the first draft and edited it, provided more detail to the discussion section and cared for the patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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