[Adult onset Still's disease (AOSD) treated with a combination of prednisolone, cyclosporin A, and methotrexate].
A 58-year-old Japanese woman developed spiking fever, polyarthralgia and hepatosplenomegaly, with highly elevated levels of c-creactive protein (CRP) and ferrtin, and elevated erythrocyte sedimentation rate (ESR). The AOSD was diagnosed according to the Yamaguchi-criteria of 1992. She was first treated with a combination of prednisolone (20 mg/day) and oral methotrexate (MTX) (7.5 mg/week). This combination, however, was not effective with tapering the dose of prednisolone. When a high dose of cyclosporin A (CyA) (5.5 mg/kg/day) was then added to MTX (5 mg/week), the patient's fever and polyarthralgia decreased, and her elevated serological parameters such as CRP and ESR also gradually declined. Finally, the dose of prednisolone was tapered to 10 mg/day. Only a few cases of AOSD treated with CyA plus MTX have been reported. Thus, further careful observation will be needed to establish the usefulness of this drug combination as a therapy for AOSD.
Division of Rheumatology, Higashihiroshima Memorial Hospital, Higashihiroshima-city.
Rie
R
Sasaki
Hirohiko
H
Shiba
Motoaki
M
Kin
Miho
M
Ohyama
Jiro
J
Yamana
Seizou
S
Yamana
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D016572:Cyclosporine / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D008727:Methotrexate