Marked effect and steroid-sparing ability of anakinra on a patient with refractory adult-onset Still’s disease

Vol.20 No.2

Case Report

Marked effect and steroid-sparing ability of anakinra on a patient with refractory adult-onset Still’s disease

Authors

Hiromichi Tamaki¹ , Hisanori Shimizu¹ , Eiji Hiraoka² , Eishi Uechi¹ , Mitsumasa Kishimoto¹ , Kenichi Yamaguchi¹ , Masato Okada¹

Section of Allergy and Rheumatology, St. Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku Tokyo, 104-8560, Japan
Department of General Internal Medicine, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe Hyogo, 650-0017, Japan

Received:

7 October 2009

Accepted:

2 November 2009

Published online:

26 December 2009

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Abstract

We report a case of refractory adult-onset Still’s disease (AOSD) successfully controlled with anakinra, an interleukin-1 (IL-1) receptor antagonist. The patient was a 23-year-old Japanese woman with AOSD who could not be induced into remission despite of two courses of pulsed methylprednisolone followed by high-dose glucocorticoid administration in conjunction with high-dose intravenously administered γ-globulin and methotrexate. To the best of our knowledge, this is the first case report in Japan of AOSD remission induced with anakinra.

Key words

Adult-onset Still’s disease - Anakinra - Steroid sparing