Adult-onset Still's disease in a patient over 80 years old successfully treated with low-dose methotrexate therapy
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 consider...
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Published in | Age and Ageing Vol. 36; no. 1; pp. 104 - 106 |
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Main Authors | , , , , , |
Format | Report |
Language | English |
Published |
Oxford University Press
01.01.2007
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Subjects | |
Online Access | Get full text |
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Summary: | 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. |
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Bibliography: | ark:/67375/HXZ-PZQ3VTZ7-D istex:D6270906509D0BD5C6478F21F73419367D4FBC96 ArticleID:afl128 |
ISSN: | 0002-0729 1468-2834 |
DOI: | 10.1093/ageing/afl128 |