title: Successful Treatment with Intravenous Cyclophosphamide for Refractory Adult-Onset Still's Disease.
abstract: We report a 64-year-old female case of intractable adult-onset Still's disease (AOSD). Initial high-dose steroid therapy combined with cyclosporin A was ineffective against macrophage-activation syndrome (MAS), which was accompanied by the systemic type of AOSD. Treatment for MAS with intravenous cyclophosphamide resulted in remission of AOSD and a reduction in the high doses of steroids. Efficacy of biologics against MAS in AOSD is unclear. Cyclophosphamide, a conventional cytotoxic agent, should be considered as one of the therapeutic options for refractory types of AOSD with MAS.
authors.affiliation: Department of General Internal Medicine and Rheumatology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Yoshika
authors.initials: Y
authors.lastname: Tsuji
authors.affiliation: Department of General Internal Medicine and Rheumatology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Nozomi
authors.initials: N
authors.lastname: Iwanaga
authors.affiliation: Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Anna
authors.initials: A
authors.lastname: Adachi
authors.affiliation: Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Kinuyo
authors.initials: K
authors.lastname: Tsunozaki
authors.affiliation: Department of General Internal Medicine and Rheumatology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Yasumori
authors.initials: Y
authors.lastname: Izumi
authors.affiliation: Department of Hematology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Moriwaki
authors.affiliation: Department of Pathology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kurohama
authors.affiliation: Department of Pathology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of Rheumatology, Nagasaki University Hospital, Nagasaki 852-8121, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
authors.affiliation: Department of General Internal Medicine and Rheumatology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Migita