title: Anakinra for myocarditis in juvenile idiopathic arthritis.
abstract: A 20-year-old pregnant woman with a history of juvenile idiopathic arthritis presented with flu-like symptoms, systemic inflammation with myocarditis, and severe cardiomyopathy. Six weeks earlier, her chronic-arthritis therapy had been changed from anakinra, an interleukin-1β receptor antagonist, to etanercept. When she resumed taking anakinra, her condition improved dramatically, including a complete recovery of ventricular function. Myocarditis is a well-recognized complication of systemic vasculitides. This unusual case emphasizes the important pathophysiologic role of interleukin receptors in the successful treatment of myocarditis. We suggest that clinical cardiologists be aware of the therapeutic usefulness of biological agents such as anakinra in patients with rheumatic conditions.
authors.affiliation: Division of Cardiology (Drs. Brown, Figueredo, Morris, and Movva), Einstein Medical Center, Philadelphia, Pennsylvania 19141; and Department of Medicine (Drs. Figueredo and Morris), Jefferson Medical College, Philadelphia, Pennsylvania 19107.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Movva
authors.affiliation: Division of Cardiology (Drs. Brown, Figueredo, Morris, and Movva), Einstein Medical Center, Philadelphia, Pennsylvania 19141; and Department of Medicine (Drs. Figueredo and Morris), Jefferson Medical College, Philadelphia, Pennsylvania 19107.
authors.forename: Suzanne B
authors.initials: SB
authors.lastname: Brown
authors.affiliation: Division of Cardiology (Drs. Brown, Figueredo, Morris, and Movva), Einstein Medical Center, Philadelphia, Pennsylvania 19141; and Department of Medicine (Drs. Figueredo and Morris), Jefferson Medical College, Philadelphia, Pennsylvania 19107.
authors.forename: D Lynn
authors.initials: DL
authors.lastname: Morris
authors.affiliation: Division of Cardiology (Drs. Brown, Figueredo, Morris, and Movva), Einstein Medical Center, Philadelphia, Pennsylvania 19141; and Department of Medicine (Drs. Figueredo and Morris), Jefferson Medical College, Philadelphia, Pennsylvania 19107.
authors.forename: Vincent M
authors.initials: VM
authors.lastname: Figueredo
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use*; D009205:Myocarditis / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D053590:Interleukin 1 Receptor Antagonist Protein
keywords: Anti-inflammatory agents/therapeutic use; antirheumatic agents/therapeutic use; arthritis, juvenile rheumatoid/complications/drug therapy; disease susceptibility; heart/drug effects; interferon-beta/therapeutic use; interleukin 1 receptor antagonist protein; myocarditis/diagnosis; treatment outcome; ventricular dysfunction, left/drug effects