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  • Title: [Adult onset Still's disease (AOSD) treated with a combination of prednisolone, cyclosporin A, and methotrexate].
    Author: Sasaki R, Shiba H, Kin M, Ohyama M, Yamana J, Yamana S.
    Journal: Ryumachi; 2003 Oct; 43(4):649-53. PubMed ID: 14598657.
    Abstract:
    A 58-year-old Japanese woman developed spiking fever, polyarthralgia and hepatosplenomegaly, with highly elevated levels of c-creactive protein (CRP) and ferrtin, and elevated erythrocyte sedimentation rate (ESR). The AOSD was diagnosed according to the Yamaguchi-criteria of 1992. She was first treated with a combination of prednisolone (20 mg/day) and oral methotrexate (MTX) (7.5 mg/week). This combination, however, was not effective with tapering the dose of prednisolone. When a high dose of cyclosporin A (CyA) (5.5 mg/kg/day) was then added to MTX (5 mg/week), the patient's fever and polyarthralgia decreased, and her elevated serological parameters such as CRP and ESR also gradually declined. Finally, the dose of prednisolone was tapered to 10 mg/day. Only a few cases of AOSD treated with CyA plus MTX have been reported. Thus, further careful observation will be needed to establish the usefulness of this drug combination as a therapy for AOSD.
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