Macrophage Activation-Like Syndrome in critically ill patients with sepsis: high risk patients with high mortality
Authors' conclusion
MALS increased in-hospital mortality in sepsis patients.
Study context
- Population
- Adults admitted to any adult ICU at Charité - Universitätsmedizin Berlin, January 2006–August 2018, with hyperferritinemia (≥500 μg/L) and sepsis, without hemophagocytic lymphohistiocytosis322 (19.8%) macrophage activation-like syndrome (MALS)
- Participants
- 1,629 adults
- Comparison
- MALS vs no MALS
- MALSn = 322
- Primary endpoint
- In-hospital mortality
Methodological detailssingle-centre
- Single-centre
Primary result
As reported in the abstract
Further findings
Bone marrow macrophages
- Increased macrophage counts and higher rates of activated macrophages in bone marrow biopsies in MALS
Monocytic HLA-DR expression
- No significant difference between the groups
Different MALS definitions
- Different definitions identified largely distinct patient populations
Original publication
Macrophage Activation-Like Syndrome in critically ill patients with sepsis: high risk patients with high mortality. Anaesth Crit Care Pain Med. Published 10 November 2025. doi:10.
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