title: Etanercept as a rescue agent in patient with adult onset Still's disease complicated with congestive heart failure.
abstract: Adult onset Still's disease (AOSD) is an uncommon disorder of unknown cause. The clinical symptoms of AOSD are a spiking fever, a typical rash, arthralgia or arthritis, sore throat, lymphadenopathy, and splenomegaly. Pleuropulmonary and cardiac involvement are rare. We report a patient with a two-year history of AOSD with myocarditis refractory to cyclosporine and glucocorticoid. Significant congestive heart failure due to left ventricle dysfunction and hyperferritinemia developed during the hospital course. After therapy with etanercept, the patient's clinical manifestations recovered and she regained normal left ventricular systolic function.
authors.affiliation: Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Armed-Forces Taichung General Hospital, No. 348, Sect.2, Chung Shan Road, Taiping 411, Taichung, Taiwan, ROC. deng6263@ms71.hinet.net
authors.forename: Deng-Ho
authors.initials: DH
authors.lastname: Yang
authors.forename: Deh-Ming
authors.initials: DM
authors.lastname: Chang
authors.forename: Jenn-Haung
authors.initials: JH
authors.lastname: Lai
authors.forename: San-Yuan
authors.initials: SY
authors.lastname: Kuo
authors.forename: Tsung-Yun
authors.initials: TY
authors.lastname: Ho
authors.forename: Kang-Min
authors.initials: KM
authors.lastname: Lin
authors.forename: Chen-Hung
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005260:Female; D005293:Ferritins / Q000097:blood; D005938:Glucocorticoids / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009205:Myocarditis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D013902:Radiography, Thoracic; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D020127:Recovery of Function; D016706:Still's Disease, Adult-Onset / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D016572:Cyclosporine; D005293:Ferritins; D000068800:Etanercept