Severe Adult-onset Still Disease with Constrictive Pericarditis and Pleuritis That Was Successfully Treated with Tocilizumab in Addition to Corticosteroids and Cyclosporin A

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  • Kawaguchi Hoshimi
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Tsuboi Hiroto
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Yagishita Mizuki
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Terasaki Toshihiko
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Terasaki Mayu
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Shimizu Masaru
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Honda Fumika
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Ohyama Ayako
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Takahashi Hiroyuki
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Miki Haruka
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Yokosawa Masahiro
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Asashima Hiromitsu
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Hagiwara Shinya
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Kondo Yuya
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Matsumoto Isao
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Sumida Takayuki
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan

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抄録

<p>Adult-onset Still disease (AOSD) is a systemic inflammatory disease characterized by fever, arthritis and rash. Corticosteroids represent a promising therapeutic option for AOSD; however, some resistant cases require immunosuppressants and biologic agents. We herein report the case of a 29-year-old Japanese man with severe AOSD, accompanied by constrictive pericarditis (CP) and pleuritis. Although 2 courses of steroid pulse and subsequent high-dose of prednisolone and cyclosporine A improved the patient's CP and pleuritis, his fever and inflammatory responses persisted. Tocilizumab (TCZ) was added to his treatment, which resulted in a rapid remission. This case suggests the usefulness of TCZ in the treatment of severe AOSD with CP and pleuritis. </p>

収録刊行物

  • Internal Medicine

    Internal Medicine 57 (7), 1033-1038, 2018

    一般社団法人 日本内科学会

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