Vol.22 No.1

Case Report

Adult-onset Still’s disease with macrophage activation syndrome successfully treated with a combination of methotrexate and etanercept

Authors

Keisuke Maeshima¹ , Koji Ishii¹ , Mikako Iwakura¹ , Misuzu Akamine¹ , Hajime Hamasaki¹ , Itomi Abe¹ , Miwa Haranaka¹ , Hiroshi Tatsukawa¹ , Hironobu Yoshimatsu¹

Received:

14 March 2011

Accepted:

23 May 2011

Published online:

14 June 2011

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Abstract

We report a 16-year-old female case of intractable adult-onset Still’s disease accompanied by macrophage activation syndrome, who went into full remission after switching from infliximab to etanercept. Although the disease promptly relapsed when etanercept was discontinued, she again responded fully upon the reintroduction of etanercept. Furthermore, the effect of etanercept was apparently enhanced by combining it with a sufficient dose of methotrexate. This combination therapy should be considered as one of treatment options for the disease.

Key words

Adult-onset Still’s disease - Macrophage activation syndrome - Etanercept - Methotrexate