title: Adult-onset Still's disease with macrophage activation syndrome successfully treated with a combination of methotrexate and etanercept.
abstract: We report a 16-year-old female case of intractable adult-onset Still's disease accompanied by macrophage activation syndrome, who went into full remission after switching from infliximab to etanercept. Although the disease promptly relapsed when etanercept was discontinued, she again responded fully upon the reintroduction of etanercept. Furthermore, the effect of etanercept was apparently enhanced by combining it with a sufficient dose of methotrexate. This combination therapy should be considered as one of treatment options for the disease.
authors.affiliation: Department of Internal Medicine I, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-cho, Yufu, Oita 879-5593, Japan. maeshima@oita-u.ac.jp
authors.forename: Keisuke
authors.initials: K
authors.lastname: Maeshima
authors.forename: Koji
authors.initials: K
authors.lastname: Ishii
authors.forename: Mikako
authors.initials: M
authors.lastname: Iwakura
authors.forename: Misuzu
authors.initials: M
authors.lastname: Akamine
authors.forename: Hajime
authors.initials: H
authors.lastname: Hamasaki
authors.forename: Itomi
authors.initials: I
authors.lastname: Abe
authors.forename: Miwa
authors.initials: M
authors.lastname: Haranaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tatsukawa
authors.forename: Hironobu
authors.initials: H
authors.lastname: Yoshimatsu
mesh_terms: D000293:Adolescent; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D055501:Macrophage Activation Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D008727:Methotrexate / Q000627:therapeutic use*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012074:Remission Induction; D016706:Still's Disease, Adult-Onset / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology
chemical_list: D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept; D008727:Methotrexate