Two Cases of Refractory Adult-Onset Still's Disease Responding to Anakinra.
- Author:
Ji Min OH
1
;
Hyungjin KIM
;
Jaejoon LEE
;
Joong Kyong AHN
;
You Sun LEE
;
Eun Mi KOH
;
Hoon Suk CHA
Author Information
1. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hoonsuk.cha@samsung.com
- Publication Type:Case Report
- Keywords:
Anakinra;
Adult-onset Still's disease (AOSD)
- MeSH:
Antirheumatic Agents;
Chest Pain;
Fever;
Humans;
Immunoglobulin G;
Immunosuppressive Agents;
Interleukin 1 Receptor Antagonist Protein;
Interleukins;
Korea;
Methotrexate;
Pharyngitis;
Receptors, Tumor Necrosis Factor;
Still's Disease, Adult-Onset;
Etanercept
- From:Korean Journal of Medicine
2012;82(4):520-524
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder with variable clinical features. The interleukin (IL)-1 receptor antagonist anakinra has been proposed as an alternative effective treatment in refractory AOSD. We report, for the first time in Korea, two cases of refractory AOSD in which anakinra treatment produced a clinical response. The first patient had frequent clinical flare-ups with fever, sore throat, myalgia, and pleuritic chest pain despite treatment with methotrexate and etanercept. In the second patient, treatments with various immunosuppressive agents failed to control the disease activity. Treatment with anakinra 100 mg/day was initiated in both cases. A complete clinical remission and improvement in the laboratory parameters were observed. The steroid dose was tapered without further clinical flare-ups. Anakinra appears to be an effective alternative treatment modality in patients with AOSD refractory to conventional disease-modifying anti-rheumatic drugs and corticosteroid therapy.
