{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:35:12Z","timestamp":1787070912770,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Macrophage activating syndrome (MAS) is a potentially life-threatening condition falling under the spectrum of secondary hemophagocytic lymphohistiocytosis, in the backdrop of rheumatological conditions. In this case of a middle-aged man, we see how an initial Epstein Barr virus infection triggered a chain of events, which after serial monitoring of labs was promptly diagnosed as MAS and treated appropriately, resulting in overall clinical improvement of the patient.<\/jats:p>","DOI":"10.4103\/ijpm.ijpm_221_24","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T06:00:09Z","timestamp":1726639209000},"page":"633-635","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["EBV-triggered secondary macrophage activation syndrome in the backdrop of lupus in an adult"],"prefix":"10.4103","volume":"68","author":[{"given":"Jay","family":"Gohri","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, JSS Medical College, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchitha","family":"Satish","sequence":"additional","affiliation":[{"name":"Department of Pathology, JSS Medical College, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua P","family":"Muniz","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Emory University, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Arellano","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Emory University, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"R1-20251031","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s12969-016-0130-4","article-title":"Macrophage activation syndrome:Different mechanisms leading to a one clinical syndrome","volume":"15","author":"Bracaglia","year":"2017","journal-title":"Pediatr Rheumatol Online J"},{"key":"R2-20251031","doi-asserted-by":"crossref","first-page":"117","DOI":"10.2147\/OARRR.S151013","article-title":"Macrophage activation syndrome:Early diagnosis is key","volume":"10","author":"Lerkvaleekul","year":"2018","journal-title":"Open Access Rheumatol"},{"key":"R3-20251031","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1002\/pbc.21039","article-title":"HLH-2004:Diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis","volume":"48","author":"Henter","year":"2007","journal-title":"Pediatr Blood Cancer"},{"key":"R5-20251031","doi-asserted-by":"crossref","first-page":"3160","DOI":"10.1002\/art.38802","article-title":"Clinical features, treatment, and outcome of macrophage activation syndrome complicating systemic juvenile idiopathic arthritis:A multinational, multicenter study of 362 patients","volume":"66","author":"Minoia","year":"2014","journal-title":"Arthritis Rheumatol"},{"key":"R6-20251031","doi-asserted-by":"crossref","first-page":"2613","DOI":"10.1002\/art.38690","article-title":"Development and validation of the HScore, a score for the diagnosis of reactive hemophagocytic syndrome","volume":"66","author":"Fardet","year":"2014","journal-title":"Arthritis Rheumatol"},{"key":"R7-20251031","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1146\/annurev-med-061813-012806","article-title":"Pathogenesis of macrophage activation syndrome and potential for cytokine- directed therapies","volume":"66","author":"Schulert","year":"2015","journal-title":"Ann Rev Med"},{"key":"R8-20251031","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1136\/annrheumdis-2018-214819","article-title":"2019 European League Against Rheumatism\/American College of Rheumatology classification criteria for systemic lupus erythematosus","volume":"78","author":"Aringer","year":"2019","journal-title":"Ann Rheum Dis"},{"key":"R9-20251031","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1177\/09612033231221414","article-title":"Immunohistochemical expression of perforin in adult systemic lupus erythematosus associated macrophage activation syndrome:Clinicohematological correlation and literature review","volume":"33","author":"Velayutham","year":"2024","journal-title":"Lupus"},{"key":"R10-20251031","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/S1525-1578(10)60535-1","article-title":"Epstein-Barr virus quantitation by real-time PCR targeting multiple gene segments","volume":"6","author":"Ryan","year":"2004","journal-title":"J Mol Diagn"},{"key":"R11-20251031","first-page":"1414","article-title":"Haemophagocytic syndrome in rheumatic patients","volume":"16","author":"Atteritano","year":"2012","journal-title":"A systematic review. Eur Rev Med Pharmacol Sci"},{"key":"R12-20251031","doi-asserted-by":"crossref","first-page":"1200289","DOI":"10.3389\/fimmu.2023.1200289","article-title":"Advances in attractive therapeutic approach for macrophage activation syndrome in COVID-19","volume":"14","author":"Chen","year":"2023","journal-title":"Front Immunol"},{"key":"R13-20251031","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.clim.2009.02.005","article-title":"Macrophage activation syndrome:Serological markers and treatment with anti-thymocyte globulin","volume":"132","author":"Coca","year":"2009","journal-title":"Clin Immunol"}],"container-title":["Indian Journal of Pathology and Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijpm.ijpm_221_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:38:48Z","timestamp":1787067528000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijpm.ijpm_221_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,18]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijpm.ijpm_221_24","relation":{},"ISSN":["0377-4929","0974-5130"],"issn-type":[{"value":"0377-4929","type":"print"},{"value":"0974-5130","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,18]]},"assertion":[{"value":"2024-03-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}