Vol.21 No.1

Case Report

Benefit and a possible risk of tocilizumab therapy for adult-onset Still’s disease accompanied by macrophage-activation syndrome

Authors

Masafumi Kobayashi¹ , Yuko Takahashi¹ , Hiroyuki Yamashita¹ , Hiroshi Kaneko¹ , Akio Mimori¹

Received:

30 March 2010

Accepted:

29 July 2010

Published online:

26 August 2010

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Abstract

We report a 57-year-old female case of intractable adult-onset Still’s disease (AOSD). Initial high-dose prednisolone therapy was ineffective, and macrophage-activation syndrome (MAS) manifested after one session of additional tocilizumab therapy. After successful treatment for MAS with lipo-dexamethasone and cyclosporin, tocilizumab therapy aided in the rapid reduction of the therapeutic steroid dose. Tocilizumab may be useful for maintenance therapy for AOSD, although its efficacy is unclear for the highly active phase of the disease.

Key words

Adult-onset Still’s disease - Tocilizumab - Macrophage-activation syndrome - Hemophagocytic lymphohistiocytosis