Egyptian evidence-based consensus on clinical practice guidelines for the diagnosis and treat-to-target management of macrophage activation syndrome in children
Abstract Background Macrophage activation syndrome (MAS) is a severe life-threatening hyperinflammatory state with uncontrolled activation and proliferation of macrophages and T-lymphocytes. MAS has variable causes and risk factors. Early diagnosis and optimum management could be lifesaving. Our aim...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-06-01
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| Series: | Egyptian Rheumatology and Rehabilitation |
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| Online Access: | https://doi.org/10.1186/s43166-022-00135-z |
| _version_ | 1811344875139891200 |
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| author | H. Lotfy M. H. Abu-Zaid S. Salah M. El Gaafary H. Abdulhady H. Salah E. Abd El-Latif Y. Farag M. Eissa S. Esam Maher A. Radwan Amira T. El-Shanawany B. M. Medhat D. El Mikkawy D. M. Mosa G. El Deriny M. Mortada N. S. Osman N. A. Fouad N. E. Elkaraly S. S. Mohamed S. A. Tabra W. A. Hassan H. Abu Shady Y. Amer S. I. Nasef Salwa Galal Y. El Miedany |
| author_facet | H. Lotfy M. H. Abu-Zaid S. Salah M. El Gaafary H. Abdulhady H. Salah E. Abd El-Latif Y. Farag M. Eissa S. Esam Maher A. Radwan Amira T. El-Shanawany B. M. Medhat D. El Mikkawy D. M. Mosa G. El Deriny M. Mortada N. S. Osman N. A. Fouad N. E. Elkaraly S. S. Mohamed S. A. Tabra W. A. Hassan H. Abu Shady Y. Amer S. I. Nasef Salwa Galal Y. El Miedany |
| author_sort | H. Lotfy |
| collection | DOAJ |
| description | Abstract Background Macrophage activation syndrome (MAS) is a severe life-threatening hyperinflammatory state with uncontrolled activation and proliferation of macrophages and T-lymphocytes. MAS has variable causes and risk factors. Early diagnosis and optimum management could be lifesaving. Our aim was to develop a consensus, evidence-based recommendations for the diagnosis, evaluation, and treat-to-target management of pediatric MAS. This study was carried out to achieve an Egyptian expert consensus on a treat-to-target management strategy for MAS using the Delphi technique. The multistep process strategy was used in developing a consensus, evidence-based treatment guidelines for MAS, started by developing 7 key clinical questions by a scientific committee according to the Patient/Population, Intervention, Comparison, and Outcomes (PICO) approach. The core leadership team identified pediatric rheumatology clinicians and researchers throughout Egypt. To generate evidence for MAS management, an evidence-based, systematic literature review was done. To obtain a consensus, the Delphi procedure (3 rounds) was used. Results Twenty-three expert panel participated in the 3 rounds with a response rate of 100%. A total of 19 recommendations, categorized into 2 sections (11 in the diagnosis section and 8 in management), were obtained. The agreement with the recommendations (ranks 7–9) ranged from 86.9 to 95.7%. The consensus was reached (i.e., ≥75% of respondents strongly agreed or agreed) on all the clinical standards. Algorithms for management have been also developed. Conclusion This was an expert, consensus recommendation for the diagnosis and treat to target of MAS, based on the best available evidence and expert opinion. The guidelines fill a gap in the literature as it presents a T2T approach for MAS. |
| first_indexed | 2024-04-13T19:54:42Z |
| format | Article |
| id | doaj.art-8713d8995de74de08f802da28ac98bc9 |
| institution | Directory Open Access Journal |
| issn | 1110-161X 2090-3235 |
| language | English |
| last_indexed | 2024-04-13T19:54:42Z |
| publishDate | 2022-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Rheumatology and Rehabilitation |
| spelling | doaj.art-8713d8995de74de08f802da28ac98bc92022-12-22T02:32:22ZengSpringerOpenEgyptian Rheumatology and Rehabilitation1110-161X2090-32352022-06-0149111710.1186/s43166-022-00135-zEgyptian evidence-based consensus on clinical practice guidelines for the diagnosis and treat-to-target management of macrophage activation syndrome in childrenH. Lotfy0M. H. Abu-Zaid1S. Salah2M. El Gaafary3H. Abdulhady4H. Salah5E. Abd El-Latif6Y. Farag7M. Eissa8S. Esam Maher9A. Radwan10Amira T. El-Shanawany11B. M. Medhat12D. El Mikkawy13D. M. Mosa14G. El Deriny15M. Mortada16N. S. Osman17N. A. Fouad18N. E. Elkaraly19S. S. Mohamed20S. A. Tabra21W. A. Hassan22H. Abu Shady23Y. Amer24S. I. Nasef25Salwa Galal26Y. El Miedany27Cairo UniversityRheumatology and Rehabilitation Department, Faculty of Medicine, Tanta UniversityCairo UniversityAin Shams UniversityAin Shams UniversityCairo UniversityAlexandria UniversityCairo UniversityCairo UniversityMinia UniversitySohag UniversityMenoufia UniversityCairo UniversityAin Shams UniversityMansoura UniversityAlexandria UniversityZagazig UniversityAssiut UniversityFayoum UniversitySuez Canal UniversityCairo UniversityRheumatology and Rehabilitation Department, Faculty of Medicine, Tanta UniversityBenha UniversityCairo UniversityZagazig UniversitySuez Canal UniversityAin Shams UniversityAin Shams UniversityAbstract Background Macrophage activation syndrome (MAS) is a severe life-threatening hyperinflammatory state with uncontrolled activation and proliferation of macrophages and T-lymphocytes. MAS has variable causes and risk factors. Early diagnosis and optimum management could be lifesaving. Our aim was to develop a consensus, evidence-based recommendations for the diagnosis, evaluation, and treat-to-target management of pediatric MAS. This study was carried out to achieve an Egyptian expert consensus on a treat-to-target management strategy for MAS using the Delphi technique. The multistep process strategy was used in developing a consensus, evidence-based treatment guidelines for MAS, started by developing 7 key clinical questions by a scientific committee according to the Patient/Population, Intervention, Comparison, and Outcomes (PICO) approach. The core leadership team identified pediatric rheumatology clinicians and researchers throughout Egypt. To generate evidence for MAS management, an evidence-based, systematic literature review was done. To obtain a consensus, the Delphi procedure (3 rounds) was used. Results Twenty-three expert panel participated in the 3 rounds with a response rate of 100%. A total of 19 recommendations, categorized into 2 sections (11 in the diagnosis section and 8 in management), were obtained. The agreement with the recommendations (ranks 7–9) ranged from 86.9 to 95.7%. The consensus was reached (i.e., ≥75% of respondents strongly agreed or agreed) on all the clinical standards. Algorithms for management have been also developed. Conclusion This was an expert, consensus recommendation for the diagnosis and treat to target of MAS, based on the best available evidence and expert opinion. The guidelines fill a gap in the literature as it presents a T2T approach for MAS.https://doi.org/10.1186/s43166-022-00135-zMacrophage activation syndromeTreat to targetEgyptian guidelines MASAlgorithm |
| spellingShingle | H. Lotfy M. H. Abu-Zaid S. Salah M. El Gaafary H. Abdulhady H. Salah E. Abd El-Latif Y. Farag M. Eissa S. Esam Maher A. Radwan Amira T. El-Shanawany B. M. Medhat D. El Mikkawy D. M. Mosa G. El Deriny M. Mortada N. S. Osman N. A. Fouad N. E. Elkaraly S. S. Mohamed S. A. Tabra W. A. Hassan H. Abu Shady Y. Amer S. I. Nasef Salwa Galal Y. El Miedany Egyptian evidence-based consensus on clinical practice guidelines for the diagnosis and treat-to-target management of macrophage activation syndrome in children Egyptian Rheumatology and Rehabilitation Macrophage activation syndrome Treat to target Egyptian guidelines MAS Algorithm |
| title | Egyptian evidence-based consensus on clinical practice guidelines for the diagnosis and treat-to-target management of macrophage activation syndrome in children |
| title_full | Egyptian evidence-based consensus on clinical practice guidelines for the diagnosis and treat-to-target management of macrophage activation syndrome in children |
| title_fullStr | Egyptian evidence-based consensus on clinical practice guidelines for the diagnosis and treat-to-target management of macrophage activation syndrome in children |
| title_full_unstemmed | Egyptian evidence-based consensus on clinical practice guidelines for the diagnosis and treat-to-target management of macrophage activation syndrome in children |
| title_short | Egyptian evidence-based consensus on clinical practice guidelines for the diagnosis and treat-to-target management of macrophage activation syndrome in children |
| title_sort | egyptian evidence based consensus on clinical practice guidelines for the diagnosis and treat to target management of macrophage activation syndrome in children |
| topic | Macrophage activation syndrome Treat to target Egyptian guidelines MAS Algorithm |
| url | https://doi.org/10.1186/s43166-022-00135-z |
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