A Case of Refractory Adult-Onset Still's Disease with High Serum Interleukin-18 Levels Treated with Monitoring of Serum Levels of Cyclosporine

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  • Horai Yoshiro
    Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center
  • Koyama Atsuko
    Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center
  • Miyamura Tomoya
    Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center
  • Hirata Akie
    Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center
  • Nakamura Masataka
    Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center
  • Ando Hitoshi
    Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center
  • Takahama Soichiro
    Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center
  • Minami. Rumi
    Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center
  • Yamamoto Masahiro
    Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center
  • Suematsu Eiichi
    Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center

Bibliographic Information

Other Title
  • 血清IL-18 高値を呈し，シクロスポリンが奏効した成人発症スチル病の1例

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Description

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.

Journal

  • 福岡醫學雜誌

    福岡醫學雜誌 103 (1), 24-28, 2012-01-25

    Fukuoka Medical Association

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