Overall, the biomarker pattern associated with the HBD + DIC phenotype closely resembled that reported in association with other MAS subsets (Additional file 1: Table S1), and the most notable differences in patients with HBD + DIC relative to sepsis controls were among biomarkers that have been associated mechanistically with the hyperinflammatory pathophysiology observed in MAS, including ferritin, IL-18, IL-6, and CXCL10 [5] (Fig. 3). This evidence concerns the gene IL18 and macrophage activation syndrome.