Severe Adult-onset Still Disease with Constrictive Pericarditis and Pleuritis That Was Successfully Treated with Tocilizumab in Addition to Corticosteroids and Cyclosporin A

Adult-onset Still disease (AOSD) is a systemic inflammatory disease characterized by fever, arthritis and rash. Corticosteroids represent a promising therapeutic option for AOSD; however, some resistant cases require immunosuppressants and biologic agents. We herein report the case of a 29-year-old...

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Bibliographic Details
Published in:Internal Medicine 2018/04/01, Vol.57(7), pp.1033-1038
Main Authors: Kawaguchi, Hoshimi, Tsuboi, Hiroto, Yagishita, Mizuki, Terasaki, Toshihiko, Terasaki, Mayu, Shimizu, Masaru, Honda, Fumika, Ohyama, Ayako, Takahashi, Hiroyuki, Miki, Haruka, Yokosawa, Masahiro, Asashima, Hiromitsu, Hagiwara, Shinya, Kondo, Yuya, Matsumoto, Isao, Sumida, Takayuki
Format: Article
Language:English
Subjects:
adult-onset Still disease
Arthritis
Case Report
constrictive pericarditis
Corticoids
Corticosteroids
Cyclosporin A
Cyclosporins
Exanthema
Fever
Immunosuppressive agents
Internal medicine
Pericarditis
Pleurisy
pleuritis
Prednisolone
Remission
tocilizumab
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Summary:Adult-onset Still disease (AOSD) is a systemic inflammatory disease characterized by fever, arthritis and rash. Corticosteroids represent a promising therapeutic option for AOSD; however, some resistant cases require immunosuppressants and biologic agents. We herein report the case of a 29-year-old Japanese man with severe AOSD, accompanied by constrictive pericarditis (CP) and pleuritis. Although 2 courses of steroid pulse and subsequent high-dose of prednisolone and cyclosporine A improved the patient's CP and pleuritis, his fever and inflammatory responses persisted. Tocilizumab (TCZ) was added to his treatment, which resulted in a rapid remission. This case suggests the usefulness of TCZ in the treatment of severe AOSD with CP and pleuritis.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.9809-17