title: A case of refractory adult-onset Still's disease with high serum interleukin-18 levels treated with monitoring of serum levels of cyclosporine.
abstract: We report the case of a 31-year-old woman who developed adult-onset Still's disease (AOSD) with a high level of serum interleukin (IL)-18. Although treated with high dose steroids, she suffered repeated remissions and her condition deteriorated. After we administered oral cyclosporine A (CsA), 200 mg/d, monitoring C2 and trough levels, her symptoms improved significantly. We decreased the dose of methylprednisolone slowly without noting a relapse. The use of CsA accompanied by C2 and trough level monitoring should be considered for refractory AOSD patients with high levels of serum IL-18.
authors.affiliation: Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan. yoshirohorai0518@qmed.hosp.go.jp
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Horai
authors.forename: Atsuko
authors.initials: A
authors.lastname: Koyama
authors.forename: Tomoya
authors.initials: T
authors.lastname: Miyamura
authors.forename: Akie
authors.initials: A
authors.lastname: Hirata
authors.forename: Masataka
authors.initials: M
authors.lastname: Nakamura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ando
authors.forename: Soichiro
authors.initials: S
authors.lastname: Takahama
authors.forename: Rumi
authors.initials: R
authors.lastname: Minami
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Eiichi
authors.initials: E
authors.lastname: Suematsu
mesh_terms: D000284:Administration, Oral; D000328:Adult; D016572:Cyclosporine / Q000008:administration & dosage* / Q000097:blood; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D020382:Interleukin-18 / Q000097:blood*; D016706:Still's Disease, Adult-Onset / Q000097:blood* / Q000188:drug therapy*
chemical_list: D020382:Interleukin-18; D016572:Cyclosporine