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Response to: ‘Effectiveness and safety of ruxolitinib for the treatment of refractory systemic idiopathic juvenile arthritis like associated with interstitial lung disease: case report’ by Bader-Meunier et al
  1. Vivian E Saper1,
  2. Guangbo Chen2,
  3. Purvesh Khatri2,
  4. Elizabeth D Mellins3
  1. 1Department of Pediatrics, Stanford University, Stanford, California, USA
  2. 2Institute for Immunity, Transplantation and Infection, Center for Biomedical Informatics, Medicine, Stanford University, Stanford, California, USA
  3. 3Department of Pediatrics, Program in Immunology, Stanford University, Stanford, California, USA
  1. Correspondence to Dr Elizabeth D Mellins, Department of Pediatrics, Program in Immunology, Stanford University, Stanford, CA 94305, USA; mellins{at}stanford.edu

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We were very interested to read the correspondence from Dr Bader-Meunier and colleagues, who report a case of systemic juvenile idiopathic arthritis (sJIA) with associated lung disease.1 This case indeed matches the description of and provides further evidence for the striking and unusual clinical characteristics we recently detailed in an international case series of such patients.2 We thank the authors for this communication.

One aspect of particular importance in the reported case is the development of drug reaction with eosinophilia and systemic symptoms (DReSS), a delayed hypersensitivity reaction, to canakinumab (monoclonal antibody to interleukin (IL)-1β). As we noted, DReSS is a possibly under-recognised event preceding the clinical recognition or development of this lung disorder in at least a subset of patients. …

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