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[Adult onset Still's disease (AOSD) treated with a combination of prednisolone, cyclosporin A, and methotrexate].

Authors
  • Sasaki, Rie
  • Shiba, Hirohiko
  • Kin, Motoaki
  • Ohyama, Miho
  • Yamana, Jiro
  • Yamana, Seizou
Type
Published Article
Journal
Ryūmachi. [Rheumatism]
Publication Date
Oct 01, 2003
Volume
43
Issue
4
Pages
649–653
Identifiers
PMID: 14598657
Source
Medline
License
Unknown

Abstract

A 58-year-old Japanese woman developed spiking fever, polyarthralgia and hepatosplenomegaly, with highly elevated levels of c-creactive protein (CRP) and ferrtin, and elevated erythrocyte sedimentation rate (ESR). The AOSD was diagnosed according to the Yamaguchi-criteria of 1992. She was first treated with a combination of prednisolone (20 mg/day) and oral methotrexate (MTX) (7.5 mg/week). This combination, however, was not effective with tapering the dose of prednisolone. When a high dose of cyclosporin A (CyA) (5.5 mg/kg/day) was then added to MTX (5 mg/week), the patient's fever and polyarthralgia decreased, and her elevated serological parameters such as CRP and ESR also gradually declined. Finally, the dose of prednisolone was tapered to 10 mg/day. Only a few cases of AOSD treated with CyA plus MTX have been reported. Thus, further careful observation will be needed to establish the usefulness of this drug combination as a therapy for AOSD.

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