Table 1.
Questions and results from on-line questionnaire
| QUESTIONS | CONSENSUS (%) |
|---|---|
| Question 1. What do you use as criteria for initiating treatment with corticosteroids with the following cardiopulmonary disease involvement? Assume that NSAIDs have not been effective. | |
| a. Presence of symptomatic pericarditis? |
Yes (100%) |
| b. Presence of symptomatic myocarditis? |
Yes (100%) |
| c. Presence of asymptomatic myocarditis (imaging only)? |
Yes (84%) |
| d. Presence of symptomatic pleural effusion? |
Yes (100%) |
| e. Presence of symptomatic pneumonitis? |
Yes (100%) |
| Question 2. Would rash alone be an indication for corticosteroids? |
No (95%) |
| Question 3. Would you consider fever alone an indication for corticosteroids? | |
| a. For 6 of last 10 days? |
Yes (75%) |
| b. For 8 of last 14 days? |
Yes (92%) |
| Question 4. Would severe fatigue (defined as inability to attend school or participate in regular activities) alone be an indication for corticosteroids? Assume no other causes identified. |
No (74%) |
| Question 5. Would you consider anemia alone to be an indication for corticosteroids? | |
| a. For Hgb less than 7 g/dl? |
Yes (100%) |
| b. For Hgb 7–9 g/dl? |
Yes (54%) |
| Question 6. Would anorexia alone be an indication for corticosteroids? Assume no other causes identified. |
No (95%) |
| Question 7. Would weight loss alone be an indication for corticosteroids? Assume no other causes identified. |
No (74%) |
| Question 8. Would low albumin alone be an indication for corticosteroids? Assume no other causes identified. |
No (95%) |
| Question 9. Would any of the findings of MAS below alone be an indication for corticosteroids? | |
| a. CNS dysfunction? |
Yes (85%) |
| b. Purpura, easy bruising, mucosal bleeding? |
Yes (85%) |
| c. Increasing ferritin? |
No (75%) |
| d. Decreasing ESR? |
No (78%) |
| e. Increasing d-dimers? |
No (71%) |
| f. Decreasing fibrinogen? |
No (61%) |
| g. Decreasing WBC? |
No (55%) |
| h. Decreasing platelets? |
Yes (58%) |
| i. Increasing LFTs? |
Yes (50%) |
| j. Hepatomegaly? |
No (84%)_ |
| Question 10. For those questions above regarding incomplete MAS to which you answered “no” (i.e. the finding alone would not be an indication for corticosteroids), would any combination of the above findings be an indication for starting corticosteroids? | |
| a. Increasing ferritin ? |
Yes (59%) |
| b. Decreasing ESR? |
Yes (59%) |
| c. Increasing d-dimers? |
Yes (59%) |
| d. Decreasing fibrinogen? |
Yes (47%) |
| e. Decreasing WBC? |
Yes (41%) |
| f. Decreasing platelets? |
Yes (35%) |
| g. Increasing LFT’s? |
Yes (53%) |
| h. Hepatomegaly? |
Yes (18%) |
| Question 11. This question refers to questions 1–9 above. For those questions to which you answered “no” (i.e. the finding alone would not be an indication for corticosteroids), would any combination of the above findings be an indication for starting corticosteroids? | |
| a. Weight loss |
Yes (69%) |
| b. Anemia |
Yes (63%) |
| c. Fever |
Yes (63%) |
| d. Rash |
Yes (60%) |
| e. Hypoalbuminemia |
Yes (50%) |
| f. Fatigue |
Yes (44%) |
| g. Asymptomatic pericarditis |
Yes (31%) |
| h. Anorexia |
Yes (31%) |
| i. Asymptomatic pleural effusions |
Yes (19%) |
| Question 12. Would you require complete resolution by imaging of pericarditis, myocarditis, pleural effusion and/or pneumonitis before tapering corticosteroids? |
No (85%) |
| Question 13. Is there a lower limit of corticosteroid dose beyond which you would not continue to taper (i.e. a maintenance dose)? | No (79%) |