Monitoring serum IL-18 levels is useful for treatment of a patient with systemic juvenile idiopathic arthritis complicated by macrophage activation syndrome.

Abstract

Systemic juvenile idiopathic arthritis (sJIA) is a systemic inflammatory disease characterized by arthritis, spiking fever and a skin rash that is frequently complicated by macrophage activation syndrome (MAS), a life-threatening disorder. We report a 22-month-old girl with sJIA who developed severe MAS but was successfully treated with corticosteroids, cyclosporin A, and non-steroidal anti-inflammatory drugs by monitoring serum IL-18 levels. IL-18 is an extremely useful cytokine for monitoring the activity of sJIA and MAS, and serum IL-18 can be used as an indicator for the effectiveness of treatment and the decision to discontinue therapy.

• Authors: Tomonari Shigemura, Takashi Yamazaki, Yosuke Hara, Jing-Ni Ou, Anne M Stevens, Hans D Ochs, Kenichi Koike, Kazunaga Agematsu
• Journal: Pediatric rheumatology online journal (Pediatr Rheumatol Online J) Vol. 9 Issue 1 Pg. 15 (Jul 13 2011) ISSN: 1546-0096 [Electronic] England
• PMID: 21749729 (Publication Type: Journal Article)