Severe hepatitis and pure red cell aplasia in adult Still's disease: good response to immunosuppressive therapy.
Adult-onset Still's disease is a systemic inflammatory disorder with a highly variable clinical course. Mild hepatitis and anemia are common manifestations. We describe a patient with adult Still's disease who developed a severe hepatitis and a life-threatening pure red cell aplasia. The hepatitis developed after treatment with NSAIDs was started. The patient was successfully treated with a combination of prednisone, cyclosporin, and methotrexate. Physicians should be aware that severe hepatitis and pure red cell aplasia can occur in adult Still's disease. We recommend a careful monitoring of liver functions in patients with adult Still's disease who are being treated with NSAIDs.
Janssen
H L
HL
Department of Hepatogastroenterology, Leiden University Medical Center, The Netherlands.
van Laar
J M
JM
van Hoek
B
B
den Ottolander
G J
GJ
van Krieken
J H
JH
Breedveld
F C
FC
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006505:Hepatitis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D012010:Red-Cell Aplasia, Pure / Q000209:etiology* / Q000473:pathology; D016706:Still's Disease, Adult-Onset / Q000150:complications* / Q000628:therapy*
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011241:Prednisone; D008727:Methotrexate