Coexistence of Macrophage Activation Syndrome, Systemic Lupus Erythematosus, and Hepatitis B: A Management Challenge

Macrophagic activation syndrome (MAS) is a rare and extremely serious syndrome with diverse etiologies.Secondary MAS often involving infections, hematological malignancies, and systemic autoimmune diseases.MAS secondary to systemic lupus erythematosus (SLE) is underdiagnosed, and its treatment has not yet been codified.It is based on a combination of corticosteroids and immunosuppressants.The presence of infection darkens the patient's vital prognosis.The coexistence of SLE and hepatitis B in the course of MAS is rarely described in the literature.Its management remains a matter of debate.We report the case of a 42-year-old woman presenting with SLE complicated by MAS at the time of diagnosis, associated with viral hepatitis B.