A case of refractory adult-onset Still's disease with high serum interleukin-18 levels treated with monitoring of serum levels of cyclosporine

• Published in: Fukuoka igaku zasshi = Hukuoka acta medica Vol. 103; no. 1; p. 24
• Main Authors: Horai, Yoshiro, Koyama, Atsuko, Miyamura, Tomoya, Hirata, Akie, Nakamura, Masataka, Ando, Hitoshi, Takahama, Soichiro, Minami, Rumi, Yamamoto, Masahiro, Suematsu, Eiichi
• Format: Journal Article
• Language: English
• Published: Japan 01.01.2012
• Subjects: Administration, Oral; Adult; Cyclosporine - administration & dosage; Cyclosporine - blood; Environmental Monitoring; Female; Humans; Interleukin-18 - blood; Still's Disease, Adult-Onset - blood; Still's Disease, Adult-Onset - drug therapy
• ISSN: 0016-254X

We report the case of a 31-year-old woman who developed adult-onset Still's disease (AOSD) with a high level of serum interleukin (IL)-18. Although treated with high dose steroids, she suffered repeated remissions and her condition deteriorated. After we administered oral cyclosporine A (CsA), 200 mg/d, monitoring C2 and trough levels, her symptoms improved significantly. We decreased the dose of methylprednisolone slowly without noting a relapse. The use of CsA accompanied by C2 and trough level monitoring should be considered for refractory AOSD patients with high levels of serum IL-18.