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This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Macrophage activation syndrome (MAS) and hemophagocytic lymphohistiocytosis (HLH) are increasingly recognized as being on a continuum, with different initiating pathways culminating in cytotoxic dysfunction and uncontrolled activation and proliferation of T lymphocytes and macrophages. The activated immune cells produce large amounts of proinflammatory cytokines, including IL-1ß and IL-6, creating a "cytokine storm"