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There is no prophylaxis for HLH or MAS, but we should all worry about the risk as it is the ONLY deadly feature of Stills. Monitoring for it is easily - I would say the slam dunk BIOMARKER for impending HLH is a skyrocketing ferritin lever (along w/ dramatic increases in LFTs). For me, my experience shows that monitoring aldolase is a great measure of Stills inflammatory activity - As long as it is elevated AOSD is active (BTW.... the CPK will be normal)