Etanercept as a rescue agent in patient with adult onset Still's disease complicated with congestive heart failure.
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.
Yang
Deng-Ho
DH
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
Chang
Deh-Ming
DM
Lai
Jenn-Haung
JH
Kuo
San-Yuan
SY
Ho
Tsung-Yun
TY
Lin
Kang-Min
KM
Chen
Chen-Hung
CH
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
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