Successful treatment of a patient with refractory adult Still's disease by tacrolimus.
Adult Still's disease (ASD) is a systemic rheumatic disease characterized by high spiking fever, erythema, polyarthritis, and increased levels of C-reactive protein, ferritin, and interleukin (IL)-18. Recently, biological agents targeting proinflammatory cytokines such as tumor necrosis factor (TNF) alpha, IL-1, and IL-6 have been described as effective treatments for refractory ASD. Herein, we present a patient with ASD, who was successfully treated by tacrolimus concomitant with corticosteroid, while infliximab and etanercept were not effective. Tacrolimus may be one of the drugs for the ASD patients refractory to the conventional treatments including TNF inhibitors.
Murakami
Kosaku
K
Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Fujii
Takao
T
Yukawa
Naoichiro
N
Yoshifuji
Hajime
H
Kawabata
Daisuke
D
Tanaka
Masao
M
Usui
Takashi
T
Mimori
Tsuneyo
T
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D016706:Still's Disease, Adult-Onset / Q000188:drug therapy*; D016559:Tacrolimus / Q000627:therapeutic use*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D000305:Adrenal Cortex Hormones; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D016559:Tacrolimus