Tocilizumab for multirefractory adult-onset Still’s disease
Unit of Rheumatology, R Ballanger Hospital, Aulnay sous Bois, France
Correspondence to:
Dr M De Bandt, Unit of Rheumatology, R Ballanger Hospital, Aulnay sous Bois, 93600, France; m.debandt@ch-aulnay.fr
Accepted 24 March 2008
| The first 150 words of the full text of this article appear below. |
Adult-onset Still’s disease (AOSD) is a multisystemic inflammatory disease of unknown cause, characterised by daily spiking fever, rash, leucocytosis and arthritis. Cytokines such as interleukin (IL)1, 6 and 18, interferon 
, tumour necrosis factor are thought to have a role in the pathogenesis of the disease.1 2 Treatments such as non-steroidal anti-inflammatory drugs, steroids, methotrexate (MTX), gold, azathioprine, leflunomide, ciclosporin and biological agents (tumour necrosis factor blockers, IL1 receptor antagonist or rituximab) can help in the management of patients, depending on presentation and disease course.3–5
We report on a young woman with refractory AOSD successfully treated with anti-IL6 receptor antibody (tocilizumab), whose efficacy has been shown in systemic onset juvenile idiopathic arthritis.
AOSD started in this patient when she was age 26. She had spiking fever, rash, arthritis, high leucocytes count, lymphadenopathy and splenomegaly, she was rheumatoid factor and antinuclear antibody negative. She was treated with non-steroidal anti-inflammatory drugs and steroids.
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