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Acquired Amegakaryocytic Thrombocytopenia in Adult-onset Still's Disease: Successful Combination Therapy with Tocilizumab and Cyclosporine
Adult-onset Still's disease (AOSD) sometimes demonstrates hematologic disorder, whereas acquired amegakaryocytic thrombocytopenia (AAT) involvement is extremely rare. We herein report a 67-year-old woman with relapse of AOSD who concomitantly developed AAT. Thrombocytopenia along with high dise...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Society of Internal Medicine
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928498/ https://www.ncbi.nlm.nih.gov/pubmed/31391399 http://dx.doi.org/10.2169/internalmedicine.2929-19 |
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author | Ichikawa, Takanori Shimojima, Yasuhiro Otuki, Toshiaki Ueno, Ken-ichi Kishida, Dai Sekijima, Yoshiki |
author_facet | Ichikawa, Takanori Shimojima, Yasuhiro Otuki, Toshiaki Ueno, Ken-ichi Kishida, Dai Sekijima, Yoshiki |
author_sort | Ichikawa, Takanori |
collection | PubMed |
description | Adult-onset Still's disease (AOSD) sometimes demonstrates hematologic disorder, whereas acquired amegakaryocytic thrombocytopenia (AAT) involvement is extremely rare. We herein report a 67-year-old woman with relapse of AOSD who concomitantly developed AAT. Thrombocytopenia along with high disease activity of AOSD was resistant to high-dose prednisolone, even in combination with methotrexate and tacrolimus. However, alternative treatment with cyclosporine after administering tocilizumab resulted in the improvement of thrombocytopenia, ultimately demonstrating that combination therapy based on suppressing the intractable disease activity of AOSD and subsequently adding a reliable immunosuppressant was required to achieve remission. |
format | Online Article Text |
id | pubmed-6928498 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | The Japanese Society of Internal Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-69284982019-12-26 Acquired Amegakaryocytic Thrombocytopenia in Adult-onset Still's Disease: Successful Combination Therapy with Tocilizumab and Cyclosporine Ichikawa, Takanori Shimojima, Yasuhiro Otuki, Toshiaki Ueno, Ken-ichi Kishida, Dai Sekijima, Yoshiki Intern Med Case Report Adult-onset Still's disease (AOSD) sometimes demonstrates hematologic disorder, whereas acquired amegakaryocytic thrombocytopenia (AAT) involvement is extremely rare. We herein report a 67-year-old woman with relapse of AOSD who concomitantly developed AAT. Thrombocytopenia along with high disease activity of AOSD was resistant to high-dose prednisolone, even in combination with methotrexate and tacrolimus. However, alternative treatment with cyclosporine after administering tocilizumab resulted in the improvement of thrombocytopenia, ultimately demonstrating that combination therapy based on suppressing the intractable disease activity of AOSD and subsequently adding a reliable immunosuppressant was required to achieve remission. The Japanese Society of Internal Medicine 2019-08-06 2019-12-01 /pmc/articles/PMC6928498/ /pubmed/31391399 http://dx.doi.org/10.2169/internalmedicine.2929-19 Text en Copyright © 2019 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Ichikawa, Takanori Shimojima, Yasuhiro Otuki, Toshiaki Ueno, Ken-ichi Kishida, Dai Sekijima, Yoshiki Acquired Amegakaryocytic Thrombocytopenia in Adult-onset Still's Disease: Successful Combination Therapy with Tocilizumab and Cyclosporine |
title | Acquired Amegakaryocytic Thrombocytopenia in Adult-onset Still's Disease: Successful Combination Therapy with Tocilizumab and Cyclosporine |
title_full | Acquired Amegakaryocytic Thrombocytopenia in Adult-onset Still's Disease: Successful Combination Therapy with Tocilizumab and Cyclosporine |
title_fullStr | Acquired Amegakaryocytic Thrombocytopenia in Adult-onset Still's Disease: Successful Combination Therapy with Tocilizumab and Cyclosporine |
title_full_unstemmed | Acquired Amegakaryocytic Thrombocytopenia in Adult-onset Still's Disease: Successful Combination Therapy with Tocilizumab and Cyclosporine |
title_short | Acquired Amegakaryocytic Thrombocytopenia in Adult-onset Still's Disease: Successful Combination Therapy with Tocilizumab and Cyclosporine |
title_sort | acquired amegakaryocytic thrombocytopenia in adult-onset still's disease: successful combination therapy with tocilizumab and cyclosporine |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928498/ https://www.ncbi.nlm.nih.gov/pubmed/31391399 http://dx.doi.org/10.2169/internalmedicine.2929-19 |
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