Steroid-resistant adult-onset Still's disease which showed a quick response to methotrexate.

Abstract

A case of steroid-resistant adult-onset Still's disease is herein reported. The patient consulted us because of night fever, arthralgia and evanescent rashes. She was diagnosed with adult-onset Still's disease, with a C-reactive protein (CRP) value of 29.5 mg/dL and serum ferritin level of 4500 ng/mL. The fever, rashes and arthralgia disappeared after medication of medium-dose oral prednisolone, however, the CRP value persisted at high levels, and the serum ferritin level nevertheless increased by 5200 ng/mL. Following the pulse therapy with corticosteroid, the CRP value decreased once but thereafter returned to a high level again. The serum ferritin level did not respond during that therapy. Finally, 10 days after starting the administration of methotrexate, the CRP value dramatically decreased from 7 mg/dL to 0.16 mg/dL, and thereafter the serum ferritin level started to decline, which thus enabled us to eventually taper the dose of oral prednisolone.

• Authors: Osamu Okamoto, Masaki Oishi, Sakuhei Fujiwara
• Journal: The Journal of dermatology (J Dermatol) Vol. 35 Issue 2 Pg. 106-10 (Feb 2008) ISSN: 0385-2407 [Print] England
• PMID: 18271807 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antirheumatic Agents
• Glucocorticoids
• Methotrexate

Topics

• Antirheumatic Agents (therapeutic use)
• Drug Resistance
• Female
• Glucocorticoids (therapeutic use)
• Humans
• Methotrexate (therapeutic use)
• Middle Aged
• Still's Disease, Adult-Onset (drug therapy)