title: Monitoring serum IL-18 levels is useful for treatment of a patient with systemic juvenile idiopathic arthritis complicated by macrophage activation syndrome.
abstract: Systemic juvenile idiopathic arthritis (sJIA) is a systemic inflammatory disease characterized by arthritis, spiking fever and a skin rash that is frequently complicated by macrophage activation syndrome (MAS), a life-threatening disorder. We report a 22-month-old girl with sJIA who developed severe MAS but was successfully treated with corticosteroids, cyclosporin A, and non-steroidal anti-inflammatory drugs by monitoring serum IL-18 levels. IL-18 is an extremely useful cytokine for monitoring the activity of sJIA and MAS, and serum IL-18 can be used as an indicator for the effectiveness of treatment and the decision to discontinue therapy.
authors.affiliation: Department of Infection and Host Defense, Shinshu University, Graduate School of Medicine, Matsumoto 390-8621, Japan. agemts_k@shinshu-u.ac.jp.
authors.forename: Tomonari
authors.initials: T
authors.lastname: Shigemura
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamazaki
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Hara
authors.forename: Jing-Ni
authors.initials: JN
authors.lastname: Ou
authors.forename: Anne M
authors.initials: AM
authors.lastname: Stevens
authors.forename: Hans D
authors.initials: HD
authors.lastname: Ochs
authors.forename: Kenichi
authors.initials: K
authors.lastname: Koike
authors.forename: Kazunaga
authors.initials: K
authors.lastname: Agematsu