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1gr methylprednisolone was started for 3 days, without improvement, increasing ferritin to 17 099 ng/mL, D dimer 37 300 ng/mL, LDH 2050 U/L, triglicerides 498 mg/dl, Hb 8.5 g/dL, platelets 68 x 10 9 /L, AST 200 U/L, ALT 179 U/L, fibrinogen 60 mg/dL, meeting Ravelli MAS criteria