Hepatic Involvement in Systemic Juvenile Idiopathic Arthritis and Macrophage Activation Syndrome: Clinical and Therapeutic Insights From 2 Cases

S. Romano, MD, Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Florence; Department of Pediatrics, School of Human Health Science, University of Florence, Florence, Italy.
M.V. Mastrolia, MD, Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Florence; Neurofarba Department, University of Florence, Florence, Italy.
C. Bracaglia, MD, Division of Rheumatology, ERN RITA Center, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy.
F. Minoia, MD, Pediatric Immunorheumatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
T. Giani, MD, PhD, Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Florence, Italy.
I. Caiello, MSc, Laboratory of Immuno-Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy.
I. Maccora, MD, PhD, Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Florence, Italy.
M. Rossano, MD, Pediatric Immunorheumatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
V. Maniscalco, MD, Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Florence, Italy.
E. Marrani, MD, Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Florence, Italy.
I. Pagnini, MD, PhD, Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Florence, Italy.
G. Simonini, MD, Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Florence; Neurofarba Department, University of Florence, Florence, Italy.

S. Romano and M.V. Mastrolia contributed equally to this article.
CONTRIBUTIONS: MVM and GS conceived and designed the concept of the study; SR and MVM acquired the data; SR and MVM drafted the paper; CB, FM, TG, IC, IM, MR, VM, EM, IP, and GS reviewed and critically revised the draft. All authors have read and agreed to the published version of the manuscript.
FUNDING: The authors declare no funding or support for this work.
COMPETING INTERESTS: The authors declare no conflicts of interest.
ETHICS AND PATIENT CONSENT: Written informed consent was obtained from the patients' parents or legal guardians. No ethical approval was required for this study.

Address correspondence to Dr. M.V. Mastrolia, Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital, IRCCS Viale Gaetano Pieraccini, 24, 50139 Firenze, Italy. Email: maria.mastrolia{at}unifi.it.