{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:35:56Z","timestamp":1787020556511,"version":"build-2736575974"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Rheumatol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Subcutaneous anakinra is an interleukin-1 inhibitor used to treat juvenile idiopathic arthritis. Recent reports suggest anakinra can be a valuable addition to the treatment of COVID-19 associated cytokine storm syndrome and the related multisystem inflammatory syndrome (MIS-C) in children. Herein, we describe our experience with intravenously administered anakinra.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>19 Patients (9 male) received intravenous (IV) anakinra for treatment of macrophage activation syndrome (MAS) secondary to systemic lupus erythematosus (SLE), systemic JIA (SJIA) or secondary hemophagocytic lymphohistiocytosis (sHLH). In most cases the general trend of the fibrinogen, ferritin, AST, and platelet count (Ravelli criteria) improved after initiation of IV anakinra. There were no reports of anaphylaxis or reactions associated with administration of IV anakinra.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Intravenous administration of anakinra is an important therapeutic option for critically ill patients with MAS\/HLH. It is also beneficial for those with thrombocytopenia, subcutaneous edema, neurological dysfunction, or very young, hospitalized patients who need multiple painful subcutaneous injections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12969-021-00585-3","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T10:26:26Z","timestamp":1624962386000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Intravenous administration of anakinra in children with macrophage activation syndrome"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4678-3034","authenticated-orcid":false,"given":"Omkar","family":"Phadke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Rouster-Stevens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Giannopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanmuganathan","family":"Chandrakasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sampath","family":"Prahalad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"issue":"2","key":"585_CR1","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1002\/art.30128","volume":"63","author":"PA Nigrovic","year":"2011","unstructured":"Nigrovic PA, Mannion M, Prince FH, Zeft A, Rabinovich CE, van Rossum MA, et al. Anakinra as first-line disease-modifying therapy in systemic juvenile idiopathic arthritis: report of forty-six patients from an international multicenter series. Arthritis Rheum. 2011;63(2):545\u201355. https:\/\/doi.org\/10.1002\/art.30128.","journal-title":"Arthritis Rheum"},{"issue":"4","key":"585_CR2","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1097\/RHU.0b013e3181a4f459","volume":"15","author":"A Zeft","year":"2009","unstructured":"Zeft A, Hollister R, LaFleur B, Sampath P, Soep J, McNally B, et al. Anakinra for systemic juvenile arthritis: the Rocky Mountain experience. J Clin Rheumatol. 2009;15(4):161\u20134. https:\/\/doi.org\/10.1097\/RHU.0b013e3181a4f459.","journal-title":"J Clin Rheumatol"},{"issue":"10","key":"585_CR3","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1007\/s00296-016-3545-9","volume":"36","author":"S Aytac","year":"2016","unstructured":"Aytac S, Batu ED, Unal S, Bilginer Y, Cetin M, Tuncer M, et al. Macrophage activation syndrome in children with systemic juvenile idiopathic arthritis and systemic lupus erythematosus. Rheumatol Int. 2016;36(10):1421\u20139. https:\/\/doi.org\/10.1007\/s00296-016-3545-9.","journal-title":"Rheumatol Int"},{"issue":"1","key":"585_CR4","doi-asserted-by":"publisher","first-page":"180","DOI":"10.3899\/jrheum.100726","volume":"38","author":"JL Record","year":"2011","unstructured":"Record JL, Beukelman T, Cron RQ. Combination therapy of abatacept and anakinra in children with refractory systemic juvenile idiopathic arthritis: a retrospective case series. J Rheumatol. 2011;38(1):180\u20131. https:\/\/doi.org\/10.3899\/jrheum.100726.","journal-title":"J Rheumatol"},{"issue":"1","key":"585_CR5","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/1546-0096-12-26","volume":"12","author":"A Shafferman","year":"2014","unstructured":"Shafferman A, Birmingham JD, Cron RQ. 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J Cereb Blood Flow Metab. 2011;31(2):439\u201347. https:\/\/doi.org\/10.1038\/jcbfm.2010.103.","journal-title":"J Cereb Blood Flow Metab"},{"issue":"6","key":"585_CR8","doi-asserted-by":"publisher","first-page":"e325","DOI":"10.1016\/S2665-9913(20)30127-2","volume":"2","author":"G Cavalli","year":"2020","unstructured":"Cavalli G, De Luca G, Campochiaro C, Della-Torre E, Ripa M, Canetti D, et al. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatol. 2020;2(6):e325\u2013e31. https:\/\/doi.org\/10.1016\/S2665-9913(20)30127-2.","journal-title":"Lancet Rheumatol"},{"issue":"9","key":"585_CR9","doi-asserted-by":"publisher","first-page":"e522","DOI":"10.1016\/S2665-9913(20)30215-0","volume":"2","author":"P Mehta","year":"2020","unstructured":"Mehta P, Cron RQ, Hartwell J, Manson JJ, Tattersall R. Intravenous anakinra for cytokine storm syndromes - Authors' reply. 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Dr Kelly Rouster-Stevens serves on the Accordant Medical Board. The remaining authors have no conflicts of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"98"}}