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Steroid‐resistant adult‐onset Still's disease which showed a quick response to methotrexate
Author(s) -
OKAMOTO Osamu,
OISHI Masaki,
FUJIWARA Sakuhei
Publication year - 2008
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/j.1346-8138.2008.00424.x
Subject(s) - prednisolone , methotrexate , ferritin , medicine , c reactive protein , serum ferritin , corticosteroid , gastroenterology , adult onset still's disease , disease , inflammation
A case of steroid‐resistant adult‐onset Still's disease is herein reported. The patient consulted us because of night fever, arthralgia and evanescent rashes. She was diagnosed with adult‐onset Still's disease, with a C‐reactive protein (CRP) value of 29.5 mg/dL and serum ferritin level of 4500 ng/mL. The fever, rashes and arthralgia disappeared after medication of medium‐dose oral prednisolone, however, the CRP value persisted at high levels, and the serum ferritin level nevertheless increased by 5200 ng/mL. Following the pulse therapy with corticosteroid, the CRP value decreased once but thereafter returned to a high level again. The serum ferritin level did not respond during that therapy. Finally, 10 days after starting the administration of methotrexate, the CRP value dramatically decreased from 7 mg/dL to 0.16 mg/dL, and thereafter the serum ferritin level started to decline, which thus enabled us to eventually taper the dose of oral prednisolone.