Double-filtration plasmapheresis for resolution of corticosteroid resistant adult onset Still's disease.

Abstract

A 45-year-old Japanese male was diagnosed with adult onset Still's disease (AOSD). High-dose corticosteroid initially resolved the illness; however, high fever, maculopalpular rashes, arthralgia, and acute pericarditis rapidly recurred, and were followed by a somnolent state without focal signs. A diagnosis of corticosteroid resistant, severe, recurrent AOSD was made, and double-filtration plasmapheresis (DFPP) was performed immediately. The somnolent state began to resolve during the first plasmapheresis procedure, and the other symptoms resolved shortly thereafter. DFPP theoretically removes monocyte-activating cytokines, such as monocyte colony-stimulating factor (M-CSF) from the circulation, and therefore may prove to be an effective treatment for corticosteroid resistant, rapidly developing cases of AOSD.

• Authors: Takashi Kato, Tatsuo Kobayashi, Hiroshi Nishino, Yuji Hidaka
• Journal: Clinical rheumatology (Clin Rheumatol) Vol. 25 Issue 4 Pg. 579-82 (Jul 2006) ISSN: 0770-3198 [Print] Germany
• PMID: 16568213 (Publication Type: Case Reports, Journal Article)

Chemical References

• Adrenal Cortex Hormones

Topics

• Adrenal Cortex Hormones (pharmacology)
• Filtration
• Humans
• Japan
• Male
• Middle Aged
• Plasmapheresis (methods)
• Recurrence
• Remission Induction
• Still's Disease, Adult-Onset (therapy)
• Tomography, X-Ray Computed
• Treatment Outcome