title: Etanercept for the treatment of intractable hemophagocytic syndrome with systemic lupus erythematosus.
abstract: A 41-year-old woman presented with continuous fever, and her laboratory data suggested the recrudescence of systemic lupus erythematosus. She was treated with 60 mg/day prednisolone. With a dose reduction of prednisolone, high fever and pancytopenia were observed again. A bone marrow biopsy revealed hemophagocytosis. The effects of steroid pulse therapy, high-dose intravenous immunoglobulin, cyclosporine A, and methotrexate were insufficient. However, after four injections of etanercept (25 mg, twice a week) subcutaneously, her symptoms had completely resolved. In such cases, therapy with etanercept may be effective.
authors.affiliation: Department of Microbiology and Immunology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan. hiro-k@med.teikyo-u.ac.jp
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Kurumi
authors.initials: K
authors.lastname: Asako
authors.forename: Maki
authors.initials: M
authors.lastname: Takayama
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Shirasaki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ono
mesh_terms: D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000627:therapeutic use*; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007279:Injections, Subcutaneous; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D051359:Lymphohistiocytosis, Hemophagocytic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008727:Methotrexate / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D020551:Pulse Therapy, Drug; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D012074:Remission Induction; D017211:Treatment Failure
chemical_list: D005938:Glucocorticoids; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D016572:Cyclosporine; D011239:Prednisolone; D000068800:Etanercept; D008727:Methotrexate