Macrophage Activation Led Acute Heart Failure Managed Successfully with Immunosuppression

Seegobin, Karan; Moustafa, Muhamad Alhaj; Majeed, Umair; Ray, Jordan; Shaikh, Marwan; Jiang, Liuyan; Tun, Han W.

doi:10.2147/jbm.s340361

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…Thus, this association to HLH may be merely coincidental, and these underlying conditions are probably not related to HLH. Such results are consistent with the literature on HLH that does not list these causes as underlying causes, at least not frequently [ 23 , 24 ]. This study has several limitations.…”

Section: Discussionsupporting

confidence: 92%

Mortality and Associated Causes in Hemophagocytic Lymphohistiocytosis: A Multiple-Cause-of-Death Analysis in France

Marle

Richard-Colmant

Fauvernier

et al. 2023

JCM

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Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome with an overall mortality rate of 40%. A multiple-cause-of-death analysis allows for the characterization of mortality and associated causes over an extended period. Death certificates, collected between 2000 and 2016 by the French Epidemiological Centre for the Medical Causes of Death (CepiDC, Inserm), containing the ICD10 codes for HLH (D76.1/2), were used to calculate HLH-related mortality rates and to compare them with the general population (observed/expected ratios, O/E). HLH was mentioned in 2072 death certificates as the underlying cause of death (UCD, n = 232) or as a non-underlying cause of death (NUCD, n = 1840). The mean age at death was 62.4 years. The age-standardized mortality rate was 1.93/million person-years and increased over the study period. When HLH was an NUCD, the most frequently associated UCDs were hematological diseases (42%), infections (39.4%), and solid tumors (10.4%). As compared to the general population, HLH decedents were more likely to have associated CMV infections or hematological diseases. The increase in mean age at death over the study period indicates progress in diagnostic and therapeutic management. This study suggests that the prognosis of HLH may be at least partially related to coexisting infections and hematological malignancies (either as causes of HLH or as complications).

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Section: Discussionsupporting

confidence: 92%

Mortality and Associated Causes in Hemophagocytic Lymphohistiocytosis: A Multiple-Cause-of-Death Analysis in France

Marle

Richard-Colmant

Fauvernier

et al. 2023

JCM

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“…Yet there are not many case reports of heart failure caused by MAS available in the literature. In recent years, only a handful of such cases were reported: one paper describing a decompensated right heart failure [ 8 ], one presenting two cases of acute heart failure treated with immunosuppression [ 9 ], and one case report of fatal acute heart failure reported by our team [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are no clear therapeutic protocols for MAS, but numerous studies have shown the effectiveness of high-dose corticosteroids, calcineurin inhibitors (cyclosporine), followed by etoposide, cyclosporine, i.v. immunoglobulins, antithymocyte globulin, or biologic drugs such as IL-1 or IL-6 inhibitors [ 2 , 8 , 9 ]. Some authors distinguish an entity similar to MAS called the macrophage activation-like syndrome (MALS), specifically in critically ill patients with sepsis rapidly progressing to an early death.…”

Section: Discussionmentioning

confidence: 99%

Acute Heart Failure in the Course of Macrophage Activation Syndrome Due to Newly Diagnosed Systemic Lupus Erythematosus: Case Presentation and Literature Review

Kuna,

Chmielewski,

Jaśkiewicz

et al. 2024

Medicina

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Macrophage activation syndrome is an uncommon yet dangerous and potentially fatal complication of many rheumatic diseases, inducing multiple organ failure, including, although rarely, acute heart failure. In the following paper, we present a case of a 37-year-old woman who, in a short period of time after a gynecological procedure due to fetal death, developed full-blown lupus erythematosus leading to early stages of macrophage activation syndrome with acute heart failure as its main clinical manifestation. We also include herein a brief literature review of the current understanding of diverse macrophage populations and their functions in various organs (focusing especially on the heart muscle), as well as a summary of different attempts at composing concise criteria for diagnosing macrophage activation syndrome.

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“…Anti-cytokine drugs may be a promising strategy in the development of cardiovascular pharmacotherapy, especially when included as part of a personalized approach [14,15]. The introduction of these types of drugs is an additional argument in support of the pro-inflammatory etiology of cardiovascular diseases and to reduce inflammation-related residual CVD risk.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic and prognostic performance of the neutrophil-to-lymphocyte ratio in acute coronary syndromes: A meta-analysis of 90 studies including 45 990 patients

Pruc,

Kubica,

Banach

et al. 2024

Pol Heart J

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Background: Cardiovascular disease is a leading cause of mortality worldwide and is likely to rise. Acute coronary syndrome (ACS) is consequent on inflammation. As a common and cost-effective inflammatory biomarker, the neutrophil-to-lymphocyte ratio (NLR) may be beneficial in cardiovascular medicine.Aims: This meta-analysis examines the diagnostic and prognostic performance of the NLR in ACS. Methods:We systematically searched PubMed Central, Medline, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and Clinicaltrial.gov databases. The search spanned from databases inception to January 10, 2024. The findings were aggregated into normalized mean differences with 95% confidence intervals.Results: Ninety articles, with 45 990 participants, were included. Pooled analysis of the NLR varied and was higher in ST-segment elevation myocardial infarction (STEMI) vs. non-ST-segment elevation myocardial infarction patients (4.94 ± 3.24 vs. 3.24 ± 2.74), acute myocardial infarction vs. unstable angina (4.47 ± 3.43 vs. 2.97 ± 1.58), ACS vs. stable angina (SA) (5.45 ± 4.28 vs. 2.46 ± 2.15), and ACS vs. controls (5.31 ± 4.01 vs. 2.46 ± 2.45). The NLR also was associated with ACS mortality, with survivors having lower results (3.67 ± 2.72 vs. 5.56 ± 3.93). Subanalysis showed that differences in the NLR were observed in STEMI survivors (4.28 ± 3.24 vs. 6.79 ± 3.98). Of ACS patients with major cardiovascular events (MACE) vs. without MACE, the NLR was 6.29 ± 4.89 vs. 3.82 ± 4.12. In STEMI patients, the NLR differed between those with and without MACE (6.99 ± 5.27 vs. 4.99 ± 4.12). Conclusions:The NLR is an effective tool for differentiating between different types of ACS. A high NLR is associated with ACS and increased MACE at 30 days. The NLR also appears to be a good predictor of MACE risk, at least in STEMI patients.

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Macrophage Activation Led Acute Heart Failure Managed Successfully with Immunosuppression

Cited by 6 publications

References 19 publications

Mortality and Associated Causes in Hemophagocytic Lymphohistiocytosis: A Multiple-Cause-of-Death Analysis in France

Mortality and Associated Causes in Hemophagocytic Lymphohistiocytosis: A Multiple-Cause-of-Death Analysis in France

Acute Heart Failure in the Course of Macrophage Activation Syndrome Due to Newly Diagnosed Systemic Lupus Erythematosus: Case Presentation and Literature Review

Diagnostic and prognostic performance of the neutrophil-to-lymphocyte ratio in acute coronary syndromes: A meta-analysis of 90 studies including 45 990 patients

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