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Peer-reviewedCC BY-NC-NDJPGN reports

Diffuse gastrointestinal hemorrhage associated with emapalumab treatment of macrophage activation syndrome: A case report

  • Samuel E. Hagman1
  • Cary P. Cavender1,2
  • David S. Willcutts1,2
  1. 1Division of Pediatric Gastroenterology, Hepatology and Nutrition University of Alabama at Birmingham Birmingham Alabama USA
  2. 2Children's of Alabama Birmingham Alabama USA
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Abstract

Macrophage activation syndrome (MAS) is a complex hyperinflammatory syndrome and continues to have evolving treatment options. This case discusses a 19‐month‐old with MAS associated liver failure and multiorgan dysfunction. Her course was complicated by gastrointestinal (GI) bleed. Emapalumab was administered (6 mg/kg) and within 24 h, her hemoglobin dropped dramatically and there was evidence of upper and lower GI bleed. Esophagogastroduodenoscopy and flexible sigmoidoscopy were performed at the bedside but did not demonstrate any source of the bleed. This case further discusses the association of emaplumab and the massive GI hemorrhage we observed as well as a review of MAS, particularly in the setting of liver failure.

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Cite

BibTeXRIS
BibTeX
@article{hagman2026diffuse,
  title = {{Diffuse gastrointestinal hemorrhage associated with emapalumab treatment of macrophage activation syndrome: A case report}},
  author = {Samuel E. Hagman and Cary P. Cavender and David S. Willcutts},
  journal = {JPGN reports},
  year = {2026},
  month = nov,
  doi = {10.1002/jpr3.70300},
  url = {https://europepmc.org/article/PMC/PMC13729233},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Diffuse gastrointestinal hemorrhage associated with emapalumab treatment of macrophage activation syndrome: A case report
AU  - Samuel E. Hagman
AU  - Cary P. Cavender
AU  - David S. Willcutts
PY  - 2026
DA  - 2026/11/03
JO  - JPGN reports
DO  - 10.1002/jpr3.70300
UR  - https://europepmc.org/article/PMC/PMC13729233
AB  - Macrophage activation syndrome (MAS) is a complex hyperinflammatory syndrome and continues to have evolving treatment options. This case discusses a 19‐month‐old with MAS associated liver failure and multiorgan dysfunction. Her course was complicated by gastrointestinal (GI) bleed. Emapalumab was administered (6 mg/kg) and within 24 h, her hemoglobin dropped dramatically and there was evidence of upper and lower GI bleed. Esophagogastroduodenoscopy and flexible sigmoidoscopy were performed at the bedside but did not demonstrate any source of the bleed. This case further discusses the association of emaplumab and the massive GI hemorrhage we observed as well as a review of MAS, particularly in the setting of liver failure.
SN  - 2691-171X
ER  -