Document Detail


Adult-onset Still's disease in a patient over 80 years old successfully treated with low-dose methotrexate therapy.
MedLine Citation:
PMID:  17158115     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Miwa Kurasawa; Kazuhiko Kotani; Gotaro Kurasawa; Kousuke Shida; Shigeki Yamada; Toshihiko Tago
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2006-12-06
Journal Detail:
Title:  Age and ageing     Volume:  36     ISSN:  0002-0729     ISO Abbreviation:  Age Ageing     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-31     Completed Date:  2007-03-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375655     Medline TA:  Age Ageing     Country:  England    
Other Details:
Languages:  eng     Pagination:  104-6     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Nishiagatsuma Welfare Hospital, Naganohara, Japan. miwa-kr@zero.ad.jp
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MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Anti-Inflammatory Agents / adverse effects,  therapeutic use
Antirheumatic Agents / therapeutic use*
Cytokines / blood
Dose-Response Relationship, Drug
Drug Therapy, Combination
Female
Humans
Methotrexate / therapeutic use*
Methylprednisolone / adverse effects,  therapeutic use
Still's Disease, Adult-Onset / drug therapy*
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antirheumatic Agents; 0/Cytokines; 59-05-2/Methotrexate; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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