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Comparison of MS score and HScore for the diagnosis of adult-onset Still’s disease-associated macrophage activation syndrome
  1. Lei Zhang,
  2. Xiaopei Yang,
  3. Tian-Fang Li,
  4. Xiaojun Liu,
  5. Shengyun Liu
  1. Rheumatology Department, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China
  1. Correspondence to Shengyun Liu, Rheumatology, Zhengzhou University First Affiliated Hospital, Zhengzhou 450052, China; fccliusy2{at}

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We read with great interest the article by Minoia et al,1 which reported MAS/sJIA (MS) score, a new scoring tool for diagnosis of systemic juvenile idiopathic arthritis (sJIA)-associated macrophage activation syndrome (MAS). This new diagnostic score has raised great interest and also some concerns.2–5 Although Wang et al2 tested the MS score in a group of Chinese patients with adult-onset Still’s disease (AOSD)-associated MAS, the diagnostic capacity needs to be evaluated in future.

HScore was first developed for the diagnosis of reactive haemophagocytic syndrome, which resulted from mainly haematological malignancy or infection,6 and was ever tested in patients with MAS, which resulted from different rheumatic diseases, with good performance.7 Since there are no studies comparing the diagnostic capability of HScore and MS score, we conducted a study to compare the capacity of HScore and MS score for the diagnosis of AOSD-associated MAS.

Patients diagnosed with AOSD during January 2012 and October 2019 in our hospital were retrospectively analysed. As …

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