title: Exacerbation of adult-onset Still's disease, possibly related to elevation of serum tumor necrosis factor-alpha after etanercept administration.
abstract: Adult-onset Still's disease (AOSD) is a systemic inflammatory disease of unknown etiology. A 44-year-old male patient presented with AOSD complicated by macrophage activation syndrome after etanercept therapy. His serum tumor necrosis factor-α (TNF-α) level was increased dramatically after etanercept therapy. The clinical course of this case suggests that the increased TNF-α level by etanercept administration might cause macrophage activation syndrome in this case.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine (Omori), Toho University School of Medicine. skawai@med.toho-u.ac.jp
authors.forename: Kaichi
authors.initials: K
authors.lastname: Kaneko
authors.forename: Makoto
authors.initials: M
authors.lastname: Kaburaki
authors.forename: Sei
authors.initials: S
authors.lastname: Muraoka
authors.forename: Nahoko
authors.initials: N
authors.lastname: Tanaka
authors.forename: Tatsuhiro
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Kusunoki
authors.forename: Haruo
authors.initials: H
authors.lastname: Abe
authors.forename: Hirahito
authors.initials: H
authors.lastname: Endo
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kawai
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects*; D000068800:Etanercept; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D018836:Inflammation Mediators / Q000097:blood*; D055501:Macrophage Activation Syndrome / Q000139:chemically induced* / Q000276:immunology / Q000628:therapy; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D010951:Plasma Exchange; D020551:Pulse Therapy, Drug; D018124:Receptors, Tumor Necrosis Factor; D016706:Still's Disease, Adult-Onset / Q000188:drug therapy* / Q000276:immunology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000097:blood*; D015854:Up-Regulation
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D018836:Inflammation Mediators; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept; D008775:Methylprednisolone