Evidence map›Paper›PMID 41397861›Full record

ArticleThe Journal of rheumatology2026

Hepatic Manifestations in Systemic Juvenile Idiopathic Arthritis and Macrophage Activation Syndrome.

Esraa Eloseily, Ivanna Romankevych, Taskin Sabit, Lara Berklite, Sarangarajan Ranganathan, Paul Rosen, Michael Henrickson, Jennifer Huggins, Grant Schulert, Alexei Grom

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Esraa EloseilyE. Eloseily, MD, MSc, University of Texas Southwestern Medical Center, and Scottish Rite Hospital for Children, Dallas, Texas, USA, and Faculty of Medicine, Assiut University, Assiut, Egypt; Esraa.eloseily@utsouthwestern.edu alexei.grom@cchmc.org.ORCID 0000-0002-4770-7383
Ivanna RomankevychI. Romankevych, MD, PhD, T. Sabit, MBBS, Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Taskin SabitI. Romankevych, MD, PhD, T. Sabit, MBBS, Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0009-0004-4950-2199
Lara BerkliteL. Berklite, MD, Department of Pathology, University of Cincinnati, and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0009-0000-7341-1642
Sarangarajan RanganathanS. Ranganathan, MD, Department of Pathology, University of Cincinnati, and Cincinnati Children's Hospital Medical Center, and UC Health University Hospital, Laboratory Medicine Building, Cincinnati, Ohio, USA.ORCID 0000-0001-6214-9167
Paul RosenP. Rosen, MD, MPH, MMM, Department of Pediatrics, Division of Pediatric Rheumatology, West Virginia University, Morgantown, West Virginia, USA.ORCID 0000-0002-6535-6564
Michael HenricksonM. Henrickson, MD, MPH, J. Huggins, MD, G. Schulert, MD, PhD, A. Grom, MD, Division of Rheumatology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA.
Jennifer HugginsM. Henrickson, MD, MPH, J. Huggins, MD, G. Schulert, MD, PhD, A. Grom, MD, Division of Rheumatology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA.
Grant SchulertM. Henrickson, MD, MPH, J. Huggins, MD, G. Schulert, MD, PhD, A. Grom, MD, Division of Rheumatology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA.ORCID 0000-0001-5923-7051
Alexei GromM. Henrickson, MD, MPH, J. Huggins, MD, G. Schulert, MD, PhD, A. Grom, MD, Division of Rheumatology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA. Esraa.eloseily@utsouthwestern.edu alexei.grom@cchmc.org.

Funding

CINCINNATI TRAINING PROGRAM IN PEDIATRIC RHEUMATOLOGYRESEARCHT32AR069512 · NIAMS · CINCINNATI CHILDRENS HOSP MED CTR · PI ALEXEI A GROM, Grant Sanford Schulert · 2016 to 2026
$1.6M
NIAMS NIH HHS T32 AR069512
6 · The paper itself

Abstract

objectiveSystemic juvenile idiopathic arthritis (sJIA) is a chronic inflammatory disease characterized by systemic features and arthritis. Macrophage activation syndrome (MAS) is a severe complication of sJIA often involving the liver. MAS confined predominantly to the liver, causing severe hepatitis, has been increasingly recognized. When liver MAS is the primary manifestation, significant hepatic injury can occur; therefore, differentiation from other forms of sJIA-related liver involvement, which may warrant distinct treatment approaches, is required. This study examined liver pathology in patients with sJIA-MAS and explored potential mechanisms.

methodsThis retrospective case series analyzed data from 4 patients with sJIA-MAS who presented with liver dysfunction and underwent core liver biopsies at Cincinnati Children's Hospital Medical Center (2019-2024).

resultsFour patients (age range 4-15 years) had elevated transaminases, with 1 meeting MAS criteria and 3 diagnosed with subclinical MAS. Liver biopsies showed portal and sinusoidal inflammatory infiltrates of CD3+ CD8+ T cells and CD163+ macrophages, with extensive hepatocellular damage, including centrilobular parenchymal collapse, multifocal necrosis, and lymphocyte-mediated bile duct injury. One case revealed features of venoocclusive disease, a novel finding. Elevated serum chemokine (C-X-C motif) ligand 9 (CXCL9) and rapid response to emapalumab (anti-interferon γ [anti-IFN-γ]) in all patients suggested IFN-γ-driven liver pathology.

conclusionThis study underscores the critical roles of CD8+ T cells, macrophages, and IFN-γ in sJIA-MAS hepatitis. Future research should explore whether serum biomarkers of IFN-γ activity can differentiate sJIA-MAS from other liver pathologies, such as drug-induced liver injury (methotrexate- or anakinra-induced) and hepatic steatosis, to guide tailored therapies.

Indexed as

Arthritis, JuvenileLiverLiver DiseasesMacrophage Activation SyndromeAdolescentBiopsyChildChild, PreschoolFemaleHumansMacrophagesMaleRetrospective Studieschemokine CXCL9cytokinesjuvenile arthritislivermacrophage activation syndromemacrophages

Identifiers

PMID41397861
PMCPMC13581259

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.