Refractory Cases of Adult Onset Still's Disease Successfully Treated with TNF-alpha Blocker.
- Author:
Inhae PARK
1
;
Min Chan PARK
;
Sang Tae CHOI
;
Yong Beom PARK
;
Soo Kon LEE
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. yongbpark@yumc.yonsei.ac.kr
- Publication Type:Case Report
- Keywords:
Adult onset Still's disease (AOSD);
Tumor necrosis factor (TNF)-alpha;
TNF-alpha blocker
- MeSH:
Adult*;
Arthritis;
Biological Factors;
Cytokines;
Diagnosis;
Exanthema;
Fever;
Humans;
Immunosuppressive Agents;
Interleukin-18;
Interleukin-8;
Interleukins;
Leukocytosis;
Still's Disease, Adult-Onset*;
Tumor Necrosis Factor-alpha*
- From:The Journal of the Korean Rheumatism Association
2005;12(4):335-340
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Adult onset Still's disease (AOSD) is a systemic inflammatory disorder of unknown etiology characterized by spiking fever, evanescent salmon-colored rash, polyarthritis and leukocytosis. The diagnosis of AOSD remains a challenge to clinicians and requires a high index of suspicion because of its rarity and nonspecific symptoms. Although the etiology and pathogenesis of AOSD is not elucidated clearly, the pathogenetic role of inflammatory cytokines, such as interleukin (IL)-6, IL-8, IL-18 and tumor necrosis factor (TNF)-alpha were suggested and the correlations of their levels with disease activity were also reported. These results raise a possibility that the blocking of these cytokines may provide a therapeutic benefit in controlling disease activity and relieving the symptoms of AOSD. Recently, we experienced two cases of AOSD, who were refractory to the treatment with high dose glucocorticoid and immunosuppressive agents. Both were treated with TNF- blockers and experienced remissions thereafter. These experiences might support the use of biologic agents in refractory AOSD.
