Glucocorticoid and cyclosporine refractory adult onset Still's disease successfully treated with tocilizumab.
Clin Rheumatol
; 28(4): 485-7, 2009 Apr.
Article
em En
| MEDLINE
| ID: mdl-19184270
ABSTRACT
We report a 29-year-old Japanese woman with disseminated intravascular coagulation (DIC) and adult onset Still's disease (AOSD). Her disease was refractory to high-dose glucocorticoids, two courses of steroid pulse therapy, and addition of cyclosporine (3.5 mg/kg/day). The serum interleukin-6 level was markedly elevated. Therefore, we administered an anti-interleukin-6 receptor antibody (tocilizumab, 8 mg/kg fortnightly), which dramatically improved her symptoms and the levels of acute-phase proteins. In addition, rapid tapering of the glucocorticoid dose was possible. Four months later, she was maintained on tocilizumab infusion once a month with low-dose steroid therapy. Cyclosporine is one of the first-line immunosuppressants for AOSD, especially when associated with DIC, hepatic failure, or hemophagocytic syndrome. In patients with cyclosporine-resistant AOSD, tocilizumab may be another useful option.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença de Still de Início Tardio
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Ciclosporina
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Coagulação Intravascular Disseminada
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Glucocorticoides
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Anticorpos Monoclonais
Limite:
Adult
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Female
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Humans
Idioma:
En
Revista:
Clin Rheumatol
Ano de publicação:
2009
Tipo de documento:
Article