title: [Severe hepatitis in a patient with adult-onset Still's disease treated with anakinra].
abstract: BACKGROUND
  Adult-onset Still's disease is characterized by non-specific polymorphic features. The efficacy of anakinra, an IL-1 receptor antagonist, has been shown in several studies. This medication is well-tolerated, and only one case of severe hepatitis has been previously reported.
  
  
  METHODS
  A 22-year-old woman presented with fever, rash, arthritis, and pericarditis, associated with systemic inflammatory response syndrome and elevated ferritin serum level with low glycosylated ferritin. Adult-onset Still's disease was diagnosed, but treatment with steroids did not achieve remission. The patient was then treated with anakinra, which resulted in spectacular improvement, but 3 weeks after the initiation of the treatment she experienced severe hepatitis that resolved after the discontinuation of anakinra.
  
  
  CONCLUSIONS
  Hepatitis is a rare side effect of anakinra and the monitoring of liver tests should be recommended during anakinra therapy.
authors.affiliation: Service de médecine interne, université Paris 13, hôpital Jean-Verdier, AP-HP, Bondy, France.
authors.forename: A
authors.initials: A
authors.lastname: Diallo
authors.forename: A
authors.initials: A
authors.lastname: Mekinian
authors.forename: L
authors.initials: L
authors.lastname: Boukari
authors.forename: H
authors.initials: H
authors.lastname: Mouas
authors.forename: M
authors.initials: M
authors.lastname: Zamy
authors.forename: P
authors.initials: P
authors.lastname: Nahon
authors.forename: M
authors.initials: M
authors.lastname: Gérin
authors.forename: O
authors.initials: O
authors.lastname: Fain
mesh_terms: D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D005260:Female; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000008:administration & dosage / Q000009:adverse effects*; D016706:Still's Disease, Adult-Onset / Q000175:diagnosis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D053590:Interleukin 1 Receptor Antagonist Protein