| Abstract | We report on an 83-year-old Japanese woman with adult-onset Still's disease (AOSD), with marked hypercytokinemia (serum levels of ferritin (Fer) and interleukin (IL)-18 were markedly high). On seeing older patients with fever of unknown origin (FUO), particularly Asians, AOSD should be considered. Reduced doses of oral prednisolone following intravenous methylprednisolone (mPSL) therapy caused a flare-up of AOSD and led to Pneumocystis carinii (jeroveci) pneumonia. Low-dose methotrexate (MTX) therapy was administered as a steroid-sparing agent with good response. Our case suggests that in very elderly people, as in younger patients, MTX is useful for controlling AOSD with marked hypercytokinemia, and avoiding corticosteroid-induced adverse effects. |
| Authors | Miwa Kurasawa, Kazuhiko Kotani, Gotaro Kurasawa, Kousuke Shida, Shigeki Yamada, Toshihiko Tago
(Affiliation: Department of Internal Medicine, Nishiagatsuma Welfare Hospital, Naganohara, Japan. miwa-kr at zero.ad.jp)
|
| Journal | Age and ageing
(Age Ageing)
Vol. 36
Issue 1
Pg. 104-6
(Jan 2007)
ISSN: 0002-0729 England |
| PMID | 17158115
(Publication Type: Case Reports, Journal Article)
|
| Chemical References |
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Cytokines
- Methotrexate
- Methylprednisolone
|
| Topics |
- Aged, 80 and over
- Anti-Inflammatory Agents
(adverse effects, therapeutic use)
- Antirheumatic Agents
(therapeutic use)
- Cytokines
(blood)
- Dose-Response Relationship, Drug
- Drug Therapy, Combination
- Female
- Humans
- Methotrexate
(therapeutic use)
- Methylprednisolone
(adverse effects, therapeutic use)
- Still's Disease, Adult-Onset
(drug therapy)
|
