Double-filtration plasmapheresis for resolution of corticosteroid resistant adult onset Still's disease.
A 45-year-old Japanese male was diagnosed with adult onset Still's disease (AOSD). High-dose corticosteroid initially resolved the illness; however, high fever, maculopalpular rashes, arthralgia, and acute pericarditis rapidly recurred, and were followed by a somnolent state without focal signs. A diagnosis of corticosteroid resistant, severe, recurrent AOSD was made, and double-filtration plasmapheresis (DFPP) was performed immediately. The somnolent state began to resolve during the first plasmapheresis procedure, and the other symptoms resolved shortly thereafter. DFPP theoretically removes monocyte-activating cytokines, such as monocyte colony-stimulating factor (M-CSF) from the circulation, and therefore may prove to be an effective treatment for corticosteroid resistant, rapidly developing cases of AOSD.
Department of Rheumatology, Kameda Medical Center, 929 Higashi-cho, Kamogawa City, Chiba, 296-8602, Japan. kintarou@s9.dion.ne.jp
Takashi
T
Kato
Tatsuo
T
Kobayashi
Hiroshi
H
Nishino
Yuji
Y
Hidaka
D000305:Adrenal Cortex Hormones / Q000494:pharmacology; D005374:Filtration; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis / Q000379:methods*; D012008:Recurrence; D012074:Remission Induction; D016706:Still's Disease, Adult-Onset / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones