A case of refractory adult-onset Still's disease with high serum interleukin-18 levels treated with monitoring of serum levels of cyclosporine.

Abstract

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.

• Authors: Yoshiro Horai, Atsuko Koyama, Tomoya Miyamura, Akie Hirata, Masataka Nakamura, Hitoshi Ando, Soichiro Takahama, Rumi Minami, Masahiro Yamamoto, Eiichi Suematsu
• Journal: Fukuoka igaku zasshi = Hukuoka acta medica (Fukuoka Igaku Zasshi) Vol. 103 Issue 1 Pg. 24-8 (Jan 2012) ISSN: 0016-254X [Print] Japan
• PMID: 22423500 (Publication Type: Case Reports, Journal Article)

Chemical References

• Interleukin-18
• Cyclosporine

Topics

• Administration, Oral
• Adult
• Cyclosporine (administration & dosage, blood)
• Environmental Monitoring
• Female
• Humans
• Interleukin-18 (blood)
• Still's Disease, Adult-Onset (blood, drug therapy)